Li Yaxiong, Cao Hong, Zhang Jingyuan
Department of Spine, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
Department of Traumatic Orthopedics, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
Front Nutr. 2025 Jun 13;12:1559674. doi: 10.3389/fnut.2025.1559674. eCollection 2025.
The Dietary Index for Gut Microbiota (DI-GM) is a novel metric developed to evaluate the diversity of intestinal microbiota. However, its relationship with osteoporosis remains uncertain.
This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2018. The DI-GM score was derived from two 24-h dietary recall interviews, while bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (QDR 4500A). Osteopenia and osteoporosis were diagnosed according to the World Health Organization (WHO) criteria. Age-standardized incidence rates (ASIRs) were calculated through direct standardization to the 2,000 U. S. standard population. Additionally, the study employed multivariate logistic regression, restricted cubic spline (RCS) analysis, mediation analysis, and subgroup analysis to explore the data comprehensively.
Weighted logistic regression analysis revealed that higher DI-GM scores were significantly negatively associated with the risk of osteoporosis. Compared to the Q1 group, the Q4 group exhibited a significantly reduced risk of osteoporosis (OR = 0.781, 95% CI: 0.693-0.869). RCS curve analysis identified a nonlinear relationship between DI-GM and osteoporosis, with a critical inflection point at 3.9. Mediation analysis demonstrated that Phenotypic Age (PA), Klemera-Doubal Method (KDM) and caffeine mediated 4.73, 4.55, and 20.33% of the association between DI-GM and osteoporosis, respectively. Furthermore, age-standardized incidence rate analysis showed that the ASIR of osteoporosis was highest among women aged 60-79 years (65.09%). The ASIR for Non-Hispanic Black individuals was significantly lower compared to other racial groups.
Higher DI-GM scores were associated with a reduced risk of developing osteoporosis, with biological age and caffeine serving as mediators in this relationship.
肠道微生物群饮食指数（DI-GM）是一种用于评估肠道微生物群多样性的新指标。然而，其与骨质疏松症的关系仍不确定。
本研究利用了2007年至2018年期间进行的美国国家健康与营养检查调查（NHANES）的数据。DI-GM得分来自两次24小时饮食回忆访谈，而骨矿物质密度（BMD）则使用双能X线吸收法（QDR 4500A）进行测量。根据世界卫生组织（WHO）标准诊断骨质减少和骨质疏松症。通过直接标准化到2000年美国标准人群来计算年龄标准化发病率（ASIR）。此外，该研究采用多变量逻辑回归、受限立方样条（RCS）分析、中介分析和亚组分析来全面探索数据。
加权逻辑回归分析显示，较高的DI-GM得分与骨质疏松症风险显著负相关。与第一四分位数组相比，第四四分位数组的骨质疏松症风险显著降低（OR = 0.781，95% CI：0.693 - 0.869）。RCS曲线分析确定DI-GM与骨质疏松症之间存在非线性关系，临界拐点为3.9。中介分析表明，表型年龄（PA）、克莱梅拉 - 杜巴尔法（KDM）和咖啡因分别介导了DI-GM与骨质疏松症之间关联的4.73%、4.55%和20.33%。此外，年龄标准化发病率分析表明，骨质疏松症的ASIR在60 - 79岁女性中最高（65.09%）。非西班牙裔黑人个体的ASIR与其他种族群体相比显著较低。
较高的DI-GM得分与骨质疏松症发病风险降低相关，生物学年龄和咖啡因是这种关系中的中介因素。
