Pro-inflammatory diet, cardio-metabolic risk factors and risk of type 2 diabetes: A cross-sectional analysis using data from RaNCD cohort study

Background Inflammation and cardiometabolic risk factors can be involved in developing type 2 diabetes mellitus (T2DM). This study aimed to investigate and compare the association between a pro-inflammatory diet and cardio-metabolic risk factors in patients with T2DM and non-T2DM cases. Methods In this cross-sectional population-based study, considering the baseline data of the Ravansar Non-Com-municable Disease (RaNCD) cohort, patients with T2DM (n = 785) and non-T2DM cases (n = 8254) were included. The dietary inflammatory index (DII) was calculated using a food frequency questionnaire (FFQ) and was classified into four groups (quartiles) with lowest to highest scores. Logistic regression analysis was conducted to determine the association between DII and cardiometabolic risk factors in both groups.Results The participants were 9,039 (4140 men and 4889 women) with a mean age of 47.4 +/- 8.2 years; the mean body mass index (BMI) and DII were 27.49 +/- 4.63 kg/m(2) and - 2.49 +/- 1.59, respectively. After adjustment for con-founding factors, we found that DII can increase the risk of T2DM by 61% (95% CI 1.27 to 2.05, P < 0.001). A comparison of two groups revealed that the association of DII, obesity/overweight and dyslipidemia were also significant in both diabetic (P < 0.05) and non-diabetic cases (P < 0.05). However, no significant association was found between DII, MetS, and hypertension in either of the groups. The association between DII and cardiovascular diseases (CVDs) was only significant in diabetic patients (1.65; 95%CI: 1.02 to 2.65, P = 0.04) and T2DM showed an interaction with the associa-tion between DII and CVDs.Conclusion Inflammatory potential of diet may increase the risk of T2DM. Although it can increase the risk of some cardiometabolic risk factors in both diabetic and non-diabetic cases, its effects were greater among patients with T2DM. However, further prospective studies are required to confirm these associations.