Luo Hong, Xia Wujie, Pan Liya
Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Nutr. 2025 Jul 2;12:1604891. doi: 10.3389/fnut.2025.1604891. eCollection 2025.
As a significant health burden, cardiovascular disease (CVD) contributes substantially to global disease and death rates. While the gut microbiota has been linked to CVD, its dietary influence remains unclear. The Dietary index for gut microbiota (DI-GM) evaluates diet-related impacts on microbiota diversity. This study explores the relationship between DI-GM and the risk of CVD.
Using National Health and Nutrition Examination Survey (NHANES) data spanning 1999-2018, this cross-sectional study included 39,181 adults aged 20 years or older, among whom were individuals with CVD. DI-GM, based on dietary recall, was calculated to assess microbiota diversity. Multivariable weighted logistic regression explored the association between DI-GM and CVD, with trend tests, subgroup analyses, smoothed curves, and multiple imputation ensuring robustness. Mediation analysis examined the role of body mass index (BMI).
A total of 39,181 participants (mean age: 47.15 years) were included, with 49.18% female and 50.82% male. Higher DI-GM levels correlated with a decreased prevalence of CVD (DI-GM: OR = 0.95, 95% CI = 0.92-0.98). Compared to participants with DI-GM scores of 0-3, those with DI-GM ≥6 had significantly lower CVD risk (OR = 0.82, 95% CI = 0.71-0.94). Restricted cubic spline analysis showed a linear association between DI-GM and CVD. A significant mediating effect of BMI was observed (proportion of mediation: 16.27%, 95% CI: 9.11%-35.48%).
An inverse association was found between the DI-GM index and CVD prevalence, where increased DI-GM scores corresponded to a lower CVD risk, partly mediated by reductions in BMI.
作为一项重大的健康负担，心血管疾病（CVD）在很大程度上导致了全球疾病和死亡率。虽然肠道微生物群与心血管疾病有关，但其饮食影响仍不清楚。肠道微生物群饮食指数（DI-GM）评估饮食对微生物群多样性的影响。本研究探讨了DI-GM与心血管疾病风险之间的关系。
利用1999年至2018年的美国国家健康与营养检查调查（NHANES）数据，这项横断面研究纳入了39181名20岁及以上的成年人，其中包括患有心血管疾病的个体。基于饮食回忆计算DI-GM，以评估微生物群多样性。多变量加权逻辑回归探讨了DI-GM与心血管疾病之间的关联，并通过趋势检验、亚组分析、平滑曲线和多重填补确保结果的稳健性。中介分析检验了体重指数（BMI）的作用。
共纳入39181名参与者（平均年龄：47.15岁），其中女性占49.18%，男性占50.82%。较高的DI-GM水平与心血管疾病患病率降低相关（DI-GM：OR = 0.95，95% CI = 0.92 - 0.98）。与DI-GM评分为0 - 3的参与者相比，DI-GM≥6的参与者心血管疾病风险显著更低（OR = 0.82，95% CI = 0.71 - 0.94）。受限立方样条分析显示DI-GM与心血管疾病之间存在线性关联。观察到BMI有显著的中介作用（中介比例：16.27%，95% CI：9.11% - 35.48%）。
发现DI-GM指数与心血管疾病患病率呈负相关，即DI-GM评分增加对应较低的心血管疾病风险，部分通过BMI降低介导。
