Zhang Xiaoyan, Wu Liangzhi, He Yutian, Zhang Shuyao, Hua Wenfeng
Department of Pharmacy, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Guangzhou, China.
Department of Gynecology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China.
Front Nutr. 2025 Aug 18;12:1624844. doi: 10.3389/fnut.2025.1624844. eCollection 2025.
The dietary index of gut microbiota (DI-GM) was developed to assess dietary quality by reflecting the diversity of the gut microbiota composition. This study examined the relationship between DI-GM and sarcopenia risk and evaluated the potential moderating effects of diet-related factors on sarcopenia risk in adult individuals.
This cross-sectional study included 8,872 adults from the National Health and Nutrition Examination Survey (NHANES) database between 2011 and 2018. Weighted multivariable logistic regression, restricted cubic splines (RCS), and subgroup analyses were used to investigate the association between DI-GM and sarcopenia. Mediation analysis was employed to examine the impact of the dietary inflammatory index (DII), systemic immune-inflammatory index (SII), and body mass index (BMI) on the relationship between DI-GM and sarcopenia.
Among the eligible participants, 773 (8.71%) had sarcopenia. The mean DI-GM value was significantly lower in the sarcopenia group than in the non-sarcopenia group (4.76 vs. 4.99, < 0.001). Multivariable logistic regression analysis revealed a negative association between DI-GM and the risk of sarcopenia, irrespective of whether the independent variable was analyzed as a continuous variable or in quartiles in the fully adjusted model (Model 3, continuous variable: OR = 0.91, 95% confidence interval (CI): 0.88-0.95, < 0.001; Q4 vs. Q1: OR = 0.67, 95% CI = 0.56-0.80, < 0.001, for trend<0.001). The RCS curves illustrated a non-linear relationship between DI-GM and sarcopenia risk. Subgroup analyses indicated an inverse relationship between DI-GM and sarcopenia risk across various covariates in the study. Mediation analysis demonstrated that 46.32, 2.29, and 29.63% of the association between DI-GM and sarcopenia was mediated by the DII, SII, and BMI, respectively.
A lower DI-GM score was strongly associated with an increased risk of sarcopenia, particularly among older adults, women, individuals with hypertension, and individuals with reduced physical activity. The DII and BMI may mediate the relationship between DI-GM and sarcopenia risk, suggesting that a diet promoting gut health could be an effective strategy for preventing sarcopenia. Additional longitudinal or interventional studies are required to substantiate the findings of this study.
肠道微生物群饮食指数（DI-GM）旨在通过反映肠道微生物群组成的多样性来评估饮食质量。本研究探讨了DI-GM与肌肉减少症风险之间的关系，并评估了饮食相关因素对成年人肌肉减少症风险的潜在调节作用。
这项横断面研究纳入了2011年至2018年美国国家健康与营养检查调查（NHANES）数据库中的8872名成年人。采用加权多变量逻辑回归、受限立方样条（RCS）和亚组分析来研究DI-GM与肌肉减少症之间的关联。采用中介分析来检验饮食炎症指数（DII）、全身免疫炎症指数（SII）和体重指数（BMI）对DI-GM与肌肉减少症关系的影响。
在符合条件的参与者中，773人（8.71%）患有肌肉减少症。肌肉减少症组的DI-GM平均值显著低于非肌肉减少症组（4.76对4.99，<0.001）。多变量逻辑回归分析显示，无论自变量在完全调整模型中作为连续变量还是四分位数进行分析，DI-GM与肌肉减少症风险之间均呈负相关（模型3，连续变量：OR = 0.91，95%置信区间（CI）：0.88 - 0.95，<0.001；Q4与Q1相比：OR = 0.67，95% CI = 0.56 - 0.80，<0.001，趋势<0.001）。RCS曲线表明DI-GM与肌肉减少症风险之间存在非线性关系。亚组分析表明，在研究的各种协变量中，DI-GM与肌肉减少症风险之间呈负相关。中介分析表明，DI-GM与肌肉减少症之间的关联分别有46.32%、2.29%和29.63%由DII、SII和BMI介导。
较低的DI-GM评分与肌肉减少症风险增加密切相关，尤其是在老年人、女性、高血压患者和身体活动减少的个体中。DII和BMI可能介导了DI-GM与肌肉减少症风险之间的关系，这表明促进肠道健康的饮食可能是预防肌肉减少症的有效策略。需要更多的纵向或干预性研究来证实本研究的结果。
