King Dana E, Xiang Jun
From the Department of Family Medicine, West Virginia University, Morgantown, WV.
J Am Board Fam Med. 2019 Nov-Dec;32(6):801-806. doi: 10.3122/jabfm.2019.06.190092.
The Dietary Inflammatory Index (DII) is a recently developed dietary inflammation assessment tool. The current study examined the association between DII and the presence and severity of diabetes in adults age ≥20 years.
Cross-sectional analysis of 4434 adult participants in the National Health and Nutrition Examination Survey (NHANES 2013 to 2014). The DII was calculated based on 24-hour dietary recall data. Linear and logistic regression models were used to estimate the relationship and control for possible confounding factors.
Among 4434 participants, mean age was 49.4 years, mean BMI (body mass index) was 29.3 kg/m, and mean DII (higher is more inflammatory) was 0.65 (range, -3.41 to +9.05). The mean DII scores in participants with and without diabetes were 0.79 and 0.50, respectively ( = .0098). Participants with Hemoglobin A1c (HgbA1c) >9% had higher DII scores than those with 6.5% to 9% HgbA1c (1.37 vs 0.54, = .0002) and those with <6.5% HgbA1c (1.37 vs 0.50, < .0001). With 1 point increase in the DII score, odds of having diabetes increased by 13% (95% CI, 1.02 to 1.24). Among the individuals with diabetes, we also observed a significant association between severity of diabetes and DII scores; with 1 point increase in DII score, the odds of having HgbA1c higher than 9% increased by 43% (95% CI, 1.21 to 1.68).
The DII had a significant association with diabetes and a stronger association when HgbA1c >9%. Further research will help clarify the association between inflammation and diet and the utility of the DII as a tool in risk assessment and management of patients with diabetes.
饮食炎症指数(DII)是最近开发的一种饮食炎症评估工具。本研究调查了年龄≥20岁成年人的DII与糖尿病的存在及严重程度之间的关联。
对国家健康与营养检查调查(2013年至2014年NHANES)中的4434名成年参与者进行横断面分析。根据24小时饮食回忆数据计算DII。使用线性和逻辑回归模型来估计这种关系并控制可能的混杂因素。
在4434名参与者中,平均年龄为49.4岁,平均体重指数(BMI)为29.3kg/m,平均DII(越高炎症性越强)为0.65(范围为-3.41至+9.05)。患有和未患有糖尿病的参与者的平均DII得分分别为0.79和0.50(P = 0.0098)。糖化血红蛋白(HgbA1c)>9%的参与者的DII得分高于HgbA1c为6.5%至9%的参与者(1.37对0.54,P = 0.0002)以及HgbA1c<6.5%的参与者(1.37对0.50,P<0.0001)。DII得分每增加1分,患糖尿病的几率增加13%(95%CI,1.02至1.24)。在患有糖尿病的个体中,我们还观察到糖尿病严重程度与DII得分之间存在显著关联;DII得分每增加1分,HgbA1c高于9%的几率增加43%(95%CI,1.21至1.68)。
DII与糖尿病存在显著关联,当HgbA1c>9%时关联更强。进一步的研究将有助于阐明炎症与饮食之间的关联以及DII作为糖尿病患者风险评估和管理工具的效用。