Huang Ying, Zhang Lei, Zeng Mengru, Liu Fuyou, Sun Lin, Liu Yu, Xiao Li
Department of Nephrology, The Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, China.
Front Nutr. 2022 Jun 14;9:899004. doi: 10.3389/fnut.2022.899004. eCollection 2022.
Diet management is a pivotal intervention for chronic kidney disease (CKD) patients. Dietary inflammation index (DII) is developed to evaluate the integral inflammatory potential of a diet pattern. However, research about the association between DII and mortality in CKD is limited.
We conducted a cohort study to investigate the relationship between energy-adjusted DII (E-DII) and the 5-year all-cause and cardiovascular mortality in CKD population.
CKD participants with complete E-DII data and death status from National Health and Nutrition Examination Survey (1999-2014) were involved in this study. E-DII was calculated based on dietary recall interviews. Smooth curve fitting, Kaplan-Meier survival analysis, and Cox proportional hazards models were used to evaluate the association between E-DII and the 5-year all cause and cardiovascular mortality. Subgroup analysis was also performed.
A total of 7,207 participants were included (55.46% elderly and 46.54% male) in this study. The 5-year all-cause and cardiovascular mortality were 16.86 and 4.32%, respectively. Smooth curve fitting showed a "J" shape and near linear relationship between the E-DII score and the 5-year all-cause and cardiovascular mortality, respectively. In multivariate Cox proportional hazards models, the hazard ratios (95% confidence intervals []) for the highest tertile of the E-DII were 1.33 (1.15, 1.54) for all-cause mortality, and 1.54 (1.15, 2.07) for cardiovascular mortality when compared with the lowest tertile of the E-DII. The subgroup analyses revealed relatively stronger associations between the E-DII and the mortality among CKD patients with other death risk factors.
Energy-adjusted dietary inflammatory index is independently related with the 5-year all-cause and cardiovascular mortality among CKD patients. Therefore, anti-inflammatory diet patterns should be recommended for CKD patients.
饮食管理是慢性肾脏病（CKD）患者的关键干预措施。饮食炎症指数（DII）旨在评估饮食模式的整体炎症潜能。然而，关于DII与CKD患者死亡率之间关联的研究有限。
我们进行了一项队列研究，以探讨能量调整后的DII（E-DII）与CKD人群5年全因死亡率和心血管死亡率之间的关系。
本研究纳入了来自国家健康与营养检查调查（1999 - 2014年）且有完整E-DII数据和死亡状态的CKD参与者。E-DII基于饮食回忆访谈进行计算。采用平滑曲线拟合、Kaplan-Meier生存分析和Cox比例风险模型来评估E-DII与5年全因死亡率和心血管死亡率之间的关联。还进行了亚组分析。
本研究共纳入7207名参与者（55.46%为老年人，46.54%为男性）。5年全因死亡率和心血管死亡率分别为16.86%和4.32%。平滑曲线拟合显示，E-DII评分与5年全因死亡率和心血管死亡率之间分别呈“J”形和近似线性关系。在多变量Cox比例风险模型中，与E-DII最低三分位数相比，E-DII最高三分位数的全因死亡率风险比（95%置信区间）为1.33（1.15，1.54），心血管死亡率风险比为1.54（1.15，2.07）。亚组分析显示，在有其他死亡风险因素的CKD患者中，E-DII与死亡率之间的关联相对更强。
能量调整后的饮食炎症指数与CKD患者5年全因死亡率和心血管死亡率独立相关。因此，应向CKD患者推荐抗炎饮食模式。
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