Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes
Abstract Background The dietary inflammatory index (DII) is a literature-derived index to assess the inflammatory potential of diet. While numerous studies have linked a higher DII score to an increased risk of mortality, there are limited studies among individuals with diabetes. Objective To invest...
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BMC
2025-06-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01771-z |
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| author | Xi Chen Lixia Lin Yuhe Tan Ya Zhu Wuxing Song Hao Wang Xufang Sun |
| author_facet | Xi Chen Lixia Lin Yuhe Tan Ya Zhu Wuxing Song Hao Wang Xufang Sun |
| author_sort | Xi Chen |
| collection | DOAJ |
| description | Abstract Background The dietary inflammatory index (DII) is a literature-derived index to assess the inflammatory potential of diet. While numerous studies have linked a higher DII score to an increased risk of mortality, there are limited studies among individuals with diabetes. Objective To investigate the association of the DII with all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality among individuals with diabetes, and to explore whether diabetes duration could modify these associations. Methods A total of 9942 participants with diabetes from the UK Biobank were included. The DII scores were calculated based on 24-h dietary data. Outcomes were ascertained from linked records. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality according to DII quartiles were estimated using Cox proportional hazards models. Results During the median follow-up period of 12.1 years, 1225 (12.3%) participants with diabetes died. The multivariable HRs (95% CIs) in the highest quartile compared with the lowest DII quartiles were 1.30 (1.06, 1.58) for mortality, 1.67 (1.13, 2.48) for CVD mortality, and 1.00 (0.73, 1.38) for cancer mortality. Spline regression analysis indicated significant nonlinear associations between DII and mortality, while the relationship with CVD mortality was linear. Moreover, diabetes duration significantly modified the association between DII and all-cause mortality (P-interaction = 0.002). In participants with diabetes duration of less than 5 years, the HR (95% CIs) for all-cause mortality in the highest versus lowest DII quartile was 1.73 (1.25, 2.39), while for those with diabetes duration of 5 years or more, the HR (95% CIs) was 1.08 (0.83, 1.39). Conclusion A higher DII, indicating a pro-inflammation dietary pattern, is associated with an elevated risk of all-cause mortality and CVD mortality in individuals with diabetes. Notably, the association with mortality is more pronounced in those with diabetes duration less than 5 years. |
| format | Article |
| id | doaj-art-1b12d2d42da34e6baca21800fdc0d70d |
| institution | DOAJ |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-1b12d2d42da34e6baca21800fdc0d70d2025-08-20T03:14:46ZengBMCDiabetology & Metabolic Syndrome1758-59962025-06-011711910.1186/s13098-025-01771-zDiabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetesXi Chen0Lixia Lin1Yuhe Tan2Ya Zhu3Wuxing Song4Hao Wang5Xufang Sun6Department of Ophthalmology, Hubei Key Laboratory of Otolaryngologic and Ophthalmic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologySchool of Physical Education and Health, Hubei University of Chinese Medicine, Hubei Shizhen LaboratoryDepartment of Ophthalmology, Hubei Key Laboratory of Otolaryngologic and Ophthalmic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyKey Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Ministry of Education, Huazhong University of Science and TechnologyKey Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Ministry of Education, Huazhong University of Science and TechnologyKey Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Ministry of Education, Huazhong University of Science and TechnologyDepartment of Ophthalmology, Hubei Key Laboratory of Otolaryngologic and Ophthalmic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background The dietary inflammatory index (DII) is a literature-derived index to assess the inflammatory potential of diet. While numerous studies have linked a higher DII score to an increased risk of mortality, there are limited studies among individuals with diabetes. Objective To investigate the association of the DII with all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality among individuals with diabetes, and to explore whether diabetes duration could modify these associations. Methods A total of 9942 participants with diabetes from the UK Biobank were included. The DII scores were calculated based on 24-h dietary data. Outcomes were ascertained from linked records. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality according to DII quartiles were estimated using Cox proportional hazards models. Results During the median follow-up period of 12.1 years, 1225 (12.3%) participants with diabetes died. The multivariable HRs (95% CIs) in the highest quartile compared with the lowest DII quartiles were 1.30 (1.06, 1.58) for mortality, 1.67 (1.13, 2.48) for CVD mortality, and 1.00 (0.73, 1.38) for cancer mortality. Spline regression analysis indicated significant nonlinear associations between DII and mortality, while the relationship with CVD mortality was linear. Moreover, diabetes duration significantly modified the association between DII and all-cause mortality (P-interaction = 0.002). In participants with diabetes duration of less than 5 years, the HR (95% CIs) for all-cause mortality in the highest versus lowest DII quartile was 1.73 (1.25, 2.39), while for those with diabetes duration of 5 years or more, the HR (95% CIs) was 1.08 (0.83, 1.39). Conclusion A higher DII, indicating a pro-inflammation dietary pattern, is associated with an elevated risk of all-cause mortality and CVD mortality in individuals with diabetes. Notably, the association with mortality is more pronounced in those with diabetes duration less than 5 years.https://doi.org/10.1186/s13098-025-01771-zDietary inflammatory indexDiabetes durationDiabetesMortalityCohort study |
| spellingShingle | Xi Chen Lixia Lin Yuhe Tan Ya Zhu Wuxing Song Hao Wang Xufang Sun Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes Diabetology & Metabolic Syndrome Dietary inflammatory index Diabetes duration Diabetes Mortality Cohort study |
| title | Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes |
| title_full | Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes |
| title_fullStr | Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes |
| title_full_unstemmed | Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes |
| title_short | Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes |
| title_sort | diabetes duration specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes |
| topic | Dietary inflammatory index Diabetes duration Diabetes Mortality Cohort study |
| url | https://doi.org/10.1186/s13098-025-01771-z |
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