Zhang Xiaoyan, Wu Liangzhi, Li Haiyan, Zhang Shuyao, Hua Wenfeng
Department of Pharmacy, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, Guangdong, China.
Department of Gynecology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, China.
Front Nutr. 2025 Apr 28;12:1583805. doi: 10.3389/fnut.2025.1583805. eCollection 2025.
Infertility poses a substantial societal and economic burden; however, current preventive strategies are limited. Recently, the relationship between gut microbiota and infertility has garnered increasing attention. The dietary index for gut microbiota (DI-GM) is a new index that reflects the diversity of the gut microbiota. However, its association with female infertility remains unclear.
This cross-sectional study included 3,053 women aged 18-45 years from the National Health and Nutrition Examination Survey (NHANES) database between 2013 and 2018. Infertility was defined based on responses to a questionnaire on reproductive health. The DI-GM score was calculated by averaging the intake from two 24-h dietary recall interviews. Weighted multivariable logistic regression, restricted cubic splines (RCS), and subgroup analyses were used to investigate the association between DI-GM and female infertility.
Based on self-reported data, 370 participants (12.12%) were classified as infertile. A higher proportion of participants with lower DI-GM scores experienced infertility. Multivariable logistic regression analysis indicated a negative association between DI-GM and the risk of female infertility, regardless of whether the independent variable was analyzed as a continuous variable or in quartiles in the fully adjusted model (Model 3, continuous variable: OR = 0.89, 95% confidence interval (CI): 0.80-0.98, = 0.025; Q4 Q1: OR = 0.63, 95% CI = 0.42-0.94, = 0.032, for trend = 0.013). The RCS curves demonstrated a non-linear relationship between the DI-GM scores and infertility risk. Subsequent subgroup analyses corroborated the robustness of these findings.
These findings suggest a non-linear relationship between DI-GM and the risk of infertility in females, with lower DI-GM scores associated with a higher risk of infertility.
不孕症带来了巨大的社会和经济负担；然而，目前的预防策略有限。最近，肠道微生物群与不孕症之间的关系越来越受到关注。肠道微生物群饮食指数（DI-GM）是反映肠道微生物群多样性的新指标。然而，其与女性不孕症的关联尚不清楚。
这项横断面研究纳入了2013年至2018年美国国家健康与营养检查调查（NHANES）数据库中3053名年龄在18至45岁之间的女性。根据生殖健康问卷的回答来定义不孕症。DI-GM得分通过对两次24小时饮食回顾访谈的摄入量进行平均计算得出。采用加权多变量逻辑回归、限制性立方样条（RCS）和亚组分析来研究DI-GM与女性不孕症之间的关联。
根据自我报告的数据，370名参与者（12.12%）被归类为不孕症患者。DI-GM得分较低的参与者中不孕症的比例更高。多变量逻辑回归分析表明，无论在完全调整模型中自变量是作为连续变量还是四分位数进行分析，DI-GM与女性不孕症风险之间均呈负相关（模型3，连续变量：OR = 0.89，95%置信区间（CI）：0.80 - 0.98，P = 0.025；Q4 vs Q1：OR = 0.63，95% CI = 0.42 - 0.94，P = 0.032，趋势P = 0.013）。RCS曲线显示DI-GM得分与不孕症风险之间存在非线性关系。随后的亚组分析证实了这些发现的稳健性。
这些发现表明DI-GM与女性不孕症风险之间存在非线性关系，DI-GM得分较低与不孕症风险较高相关。
