Dose-response relationship between dietary inflammatory index and diabetic kidney disease in US adults

Objective: The impact of the dietary potential inflammatory effect on diabetic kidney disease (DKD) has not been adequately investigated. The present study aimed to explore the association between dietary inflammatory index (DII) and DKD in US adults. Design: This is a cross-sectional study. Setting: Data from the National Health and Nutrition Examination Survey (2007-2016) were used. DII was calculated from 24-h dietary recall interviews. DKD was defined as diabetes with albuminuria, impaired glomerular filtration rate or both. Logistic regression and restricted cubic spline models were adopted to evaluate the associations. Participants: Data from the National Health and Nutrition Examination Survey (2007-2016) were used, which can provide the information of participants. Results: Four thousand two-hundred and sixty-four participants were included in this study. The adjusted OR of DKD was 1 center dot 04 (95 % CI 0 center dot 81, 1 center dot 36) for quartile 2, 1 center dot 24 (95 % CI 0 center dot 97, 1 center dot 59) for quartile 3 and 1 center dot 64 (95 % CI 1 center dot 24, 2 center dot 17) for quartile 4, respectively, compared with the quartile 1 of DII. A linear dose-response pattern was observed between DII and DKD (P (nonlinearity) = 0 center dot 73). In the stratified analyses, the OR for quartile 4 of DII were significant among adults with higher educational level (OR 1 center dot 83, 95 % CI 1 center dot 26, 2 center dot 66) and overweight or obese participants (OR 1 center dot 67, 95 % CI 1 center dot 23, 2 center dot 28), but not among the corresponding another subgroup. The interaction effects between DII and stratified factors on DKD were not statistically significant (all P values for interactions were >0 center dot 05). Conclusions: Our findings suggest that a pro-inflammatory diet, shown by a higher DII score, is associated with increased odd of DKD.