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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Main Authors: Xi Chen, Lixia Lin, Yuhe Tan, Ya Zhu, Wuxing Song, Hao Wang, Xufang Sun
Format: Article
Language:English
Published: BMC 2025-06-01
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.
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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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