Chen Qiujin, Ou Liang
Department of Immunization, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, 214023, China.
Department of Infection Control, Wuxi No.2 People's Hospital, Wuxi, 214000, China.
Eur J Clin Nutr. 2025 Jan;79(1):7-14. doi: 10.1038/s41430-024-01493-x. Epub 2024 Aug 13.
To explore the relationship between Dietary Inflammatory Index (DII) and chronic kidney disease (CKD) risk, we obtained 6 studies (3 prospective studies and 3 cross-sectional studies) from PubMed, CBM, Cochrane Library, and Embase, as of March 6, 2023. Our results revealed a positive link between the CKD risk and rising DII that signified a pro-inflammatory diet. With medium heterogeneity (Overall RR = 1.44, 95%CI: 1.22, 1.71; I = 64.7%, P = 0.015), individuals in the highest DII exposure category had a 44% greater overall risk of developing CKD than those in the lowest DII exposure category. According to risk estimations from cross-sectional studies, individuals in the highest DII exposure category had a 64% higher risk of developing CKD than those in the lowest DII exposure category, with significant heterogeneity (RR = 1.64, 95%CI: 1.18, 2.29; I = 70.9%, P = 0.032). The risk estimates in cohort studies revealed individuals in the highest DII exposure category had a 28% higher risk of CKD than those in the lowest DII exposure category, with a low heterogeneity (RR = 1.28, 95%CI: 1.14, 1.44; I = 17.2%, P = 0.015). Cross-sectional studies showed a nonlinear dose-response relationship between DII and CKD risk, while cohort studies indicated a linear dose-response relationship. Meta-regression results showed publication year, study design, and country had no significant correlation with the meta-analysis. The subgroup analysis results remained consistent. Results support the significance and importance of adopting a better anti-inflammatory diet in preventing CKD. These findings further confirm DII as a tool of the inflammatory potential of the diet to prevent and delay the onset and progression of CKD.
为探究饮食炎症指数（DII）与慢性肾脏病（CKD）风险之间的关系，截至2023年3月6日，我们从PubMed、中国生物医学文献数据库（CBM）、考克兰图书馆和Embase中获取了6项研究（3项前瞻性研究和3项横断面研究）。我们的研究结果显示，CKD风险与饮食炎症指数升高之间存在正相关，这意味着促炎饮食。存在中度异质性（总体风险比RR = 1.44，95%置信区间CI：1.22，1.71；I² = 64.7%，P = 0.015），饮食炎症指数暴露最高组的个体患CKD的总体风险比饮食炎症指数暴露最低组的个体高44%。根据横断面研究的风险估计，饮食炎症指数暴露最高组的个体患CKD的风险比饮食炎症指数暴露最低组的个体高64%，存在显著异质性（RR = 1.64，95%CI：1.18，2.29；I² = 70.9%，P = 0.032）。队列研究中的风险估计显示，饮食炎症指数暴露最高组的个体患CKD的风险比饮食炎症指数暴露最低组的个体高28%，异质性较低（RR = 1.28，95%CI：1.14，1.44；I² = 17.2%，P = 0.015）。横断面研究显示饮食炎症指数与CKD风险之间存在非线性剂量反应关系，而队列研究表明存在线性剂量反应关系。Meta回归结果显示发表年份、研究设计和国家与Meta分析无显著相关性。亚组分析结果保持一致。研究结果支持采用更好的抗炎饮食在预防CKD方面的意义和重要性。这些发现进一步证实饮食炎症指数可作为衡量饮食炎症潜力的工具，用于预防和延缓CKD的发病及进展。
