Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes

BackgroundThe Gut Microbiota Dietary Index (DI-GM) is a newly developed assessment tool that quantitatively evaluates the nutritional modulation of intestinal microbial communities through systematic characterization of diet-microbiome interactions. The relationship between DI-GM and the risk of dea...

Full description

Saved in:
Bibliographic Details
Main Authors: Wenjing Song, Daoqin Liu, Zihe Xing, Luqing Jiang, Yu Tang, Zichen Xu, Lei Li, Shuai Yan, Xia Fu, Yuping Wang, Qiwen Wu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Nutrition
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1621277/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849239486988288000
author Wenjing Song
Daoqin Liu
Zihe Xing
Luqing Jiang
Yu Tang
Zichen Xu
Lei Li
Shuai Yan
Xia Fu
Yuping Wang
Qiwen Wu
author_facet Wenjing Song
Daoqin Liu
Zihe Xing
Luqing Jiang
Yu Tang
Zichen Xu
Lei Li
Shuai Yan
Xia Fu
Yuping Wang
Qiwen Wu
author_sort Wenjing Song
collection DOAJ
description BackgroundThe Gut Microbiota Dietary Index (DI-GM) is a newly developed assessment tool that quantitatively evaluates the nutritional modulation of intestinal microbial communities through systematic characterization of diet-microbiome interactions. The relationship between DI-GM and the risk of death has not been elucidated in patients with diabetes or prediabetes. The present cohort study examined the longitudinal relationship between DI-GM scores and both overall mortality and mortality from cardiovascular disease in this clinically vulnerable population.MethodThe investigation used data from the National Health and Nutrition Examination Survey (NHANES) 2007–2018. Analytical approaches, including multivariable-adjusted Cox proportional hazards regression, restricted cubic spline (RCS) modeling, stratified subgroup evaluations, and sensitivity assessments, were employed to examine the relationships linking DI-GM scores to mortality outcomes among individuals with diabetes or prediabetes.ResultDuring an average monitoring duration of 77.39 months within the cohort of 8,409 participants, 1,430 fatalities from all causes were documented, including 381 cases attributed to cardiovascular events. Multivariable-adjusted Cox regression analyses showed a negative correlation, with a 1-unit increase in DI-GM corresponding to an 8% lower all-cause mortality risk (HR = 0.92, 95% CI: 0.89–0.95; p < 0.001) and an 11% reduction in cardiovascular-specific mortality (HR = 0.89, 95% CI: 0.83–0.95; p < 0.001). When comparing extreme quartiles of DI-GM distribution, participants in the highest quartile exhibited 26% lower all-cause mortality (HR = 0.74, 95% CI: 0.63–0.87; p < 0.001; trend p < 0.05) and 30% lower cardiovascular mortality (HR = 0.70, 95% CI: 0.52–0.96; p = 0.025; trend p < 0.05) than those in the lowest quartile. Subgroup analyses confirmed the consistency of the results in most categories. Restricted cubic splines demonstrated negative correlations between DI-GM and both mortality outcomes. The Beneficial Gut Microbiota Score (BGMS) exhibited inverse associations with mortality risks, while the Unfavorable Gut Microbiota Score (UGMS) showed no significant relationship. In the sensitive analysis, the robustness of multiple interpolation results was verified by deleting missing data.ConclusionAmong patients with diabetes or prediabetes, elevated DI-GM levels were negatively correlated with all-cause mortality and cardiovascular mortality risks.
format Article
id doaj-art-d67e7f8e24844e62b886c7ffdf658b54
institution Kabale University
issn 2296-861X
language English
publishDate 2025-08-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Nutrition
spelling doaj-art-d67e7f8e24844e62b886c7ffdf658b542025-08-20T04:00:56ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-08-011210.3389/fnut.2025.16212771621277Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetesWenjing Song0Daoqin Liu1Zihe Xing2Luqing Jiang3Yu Tang4Zichen Xu5Lei Li6Shuai Yan7Xia Fu8Yuping Wang9Qiwen Wu10Department of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Nephrology, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital, Wannan Medical College, Wuhu, Anhui, ChinaBackgroundThe Gut Microbiota Dietary Index (DI-GM) is a newly developed assessment tool that quantitatively evaluates the nutritional modulation of intestinal microbial communities through systematic characterization of diet-microbiome interactions. The relationship between DI-GM and the risk of death has not been elucidated in patients with diabetes or prediabetes. The present cohort study examined the longitudinal relationship between DI-GM scores and both overall mortality and mortality from cardiovascular disease in this clinically vulnerable population.MethodThe investigation used data from the National Health and Nutrition Examination Survey (NHANES) 2007–2018. Analytical approaches, including multivariable-adjusted Cox proportional hazards regression, restricted cubic spline (RCS) modeling, stratified subgroup evaluations, and sensitivity assessments, were employed to examine the relationships linking DI-GM scores to mortality outcomes among individuals with diabetes or prediabetes.ResultDuring an average monitoring duration of 77.39 months within the cohort of 8,409 participants, 1,430 fatalities from all causes were documented, including 381 cases attributed to cardiovascular events. Multivariable-adjusted Cox regression analyses showed a negative correlation, with a 1-unit increase in DI-GM corresponding to an 8% lower all-cause mortality risk (HR = 0.92, 95% CI: 0.89–0.95; p < 0.001) and an 11% reduction in cardiovascular-specific mortality (HR = 0.89, 95% CI: 0.83–0.95; p < 0.001). When comparing extreme quartiles of DI-GM distribution, participants in the highest quartile exhibited 26% lower all-cause mortality (HR = 0.74, 95% CI: 0.63–0.87; p < 0.001; trend p < 0.05) and 30% lower cardiovascular mortality (HR = 0.70, 95% CI: 0.52–0.96; p = 0.025; trend p < 0.05) than those in the lowest quartile. Subgroup analyses confirmed the consistency of the results in most categories. Restricted cubic splines demonstrated negative correlations between DI-GM and both mortality outcomes. The Beneficial Gut Microbiota Score (BGMS) exhibited inverse associations with mortality risks, while the Unfavorable Gut Microbiota Score (UGMS) showed no significant relationship. In the sensitive analysis, the robustness of multiple interpolation results was verified by deleting missing data.ConclusionAmong patients with diabetes or prediabetes, elevated DI-GM levels were negatively correlated with all-cause mortality and cardiovascular mortality risks.https://www.frontiersin.org/articles/10.3389/fnut.2025.1621277/fulldietary index of gut microbiota (DI-GM)diabetesprediabetesall-cause mortalitycardiovascular mortality
spellingShingle Wenjing Song
Daoqin Liu
Zihe Xing
Luqing Jiang
Yu Tang
Zichen Xu
Lei Li
Shuai Yan
Xia Fu
Yuping Wang
Qiwen Wu
Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes
Frontiers in Nutrition
dietary index of gut microbiota (DI-GM)
diabetes
prediabetes
all-cause mortality
cardiovascular mortality
title Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes
title_full Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes
title_fullStr Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes
title_full_unstemmed Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes
title_short Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes
title_sort association of the newly proposed dietary index for gut microbiota and all cause and cardiovascular mortality among individuals with diabetes and prediabetes
topic dietary index of gut microbiota (DI-GM)
diabetes
prediabetes
all-cause mortality
cardiovascular mortality
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1621277/full
work_keys_str_mv AT wenjingsong associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT daoqinliu associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT zihexing associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT luqingjiang associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT yutang associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT zichenxu associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT leili associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT shuaiyan associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT xiafu associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT yupingwang associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes
AT qiwenwu associationofthenewlyproposeddietaryindexforgutmicrobiotaandallcauseandcardiovascularmortalityamongindividualswithdiabetesandprediabetes