Dietary Inflammatory Index and All-Cause Mortality in Older Adults with Hypertension: Results from NHANES

Association between the dietary inflammatory index and all-cause mortality in osteoarthritis

BACKGROUND

To investigate the association between the Dietary Inflammatory Index (DII) and all-cause mortality in patients with osteoarthritis (OA).

METHODS

In this retrospective cohort study, data on OA patients were obtained from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. OA diagnosis was self-reported. The study population was divided into low and high DII groups based on the DII's median. All-cause mortality was the outcome, which was determined via linkage to the National Death Index (NDI) until 31 December 2019. Multivariable Cox regression analyses were employed to investigate the association between the DII and all-cause mortality. The survival of the low and high DII groups was exhibited by Kaplan-Meier curves. Furthermore, subgroup analyses were carried out in terms of age and comorbidity.

RESULTS

A total of 3804 patients with OA were included, with 1902 (50%) in the low DII group and 1902 (50%) in the high DII group. Patients with a high DII had a significantly greater risk of all-cause mortality than those with a low DII (HR = 1.21, 95%CI: 1.02-1.44, P = 0.025). A high DII was associated with a significantly increased risk of all-cause mortality compared with a low DII in patients aged ≥ 65 years [hazard ratio (HR) = 1.28, 95% confidence level (CI): 1.07-1.53, P = 0.006). Hypertensive patients with a high DII had a significantly greater risk of all-cause mortality than those with a low DII (HR = 1.25, 95%CI: 1.03-1.52, P = 0.025). For patients with cardiovascular disease (CVD), a high DII was associated with a significantly higher risk of all-cause mortality than a low DII (HR = 1.43, 95%CI: 1.17-1.75, P < 0.001). A high DII was associated with a significantly greater risk of all-cause mortality, as compared with a low DII in patients with chronic kidney disease (CKD) (HR = 1.22, 95%CI: 1.02-1.45, P = 0.026).

CONCLUSION

The DII was positively associated with the risk of all-cause mortality in patients with OA. This association differed by age, hypertension, CVD, and CKD. Adherence to diet with a low DII may be beneficial in prognosis improvement.

Association between the dietary inflammatory index and all-cause and cardiovascular mortality in patients with atherosclerotic cardiovascular disease

BACKGROUND AND AIMS

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide. Inflammation is pivotal in atherosclerosis development. The dietary inflammatory index (DII) is a tool to quantify the overall inflammatory potential of diet. The association between DII and all-cause and cardiovascular mortality in ASCVD patients remains undetermined.

METHODS AND RESULTS

Participants included individuals with ASCVD from the National Health and Nutrition Examination Survey from 1999 to 2018. A total of 5006 participants were included, during a median of 6.6 years of follow-up, of which 2220 (44.4 %) were dead. The Cox proportional hazard model evaluated the association between DII and all-cause and cardiovascular mortality. Participants in the higher DII quartile exhibited a higher mortality of ASCVD. Compared with the patients in quartile 1, those in quartile 4 had a 34 % increased risk for all-cause mortality (HR = 1.34, 95 % CI = 1.21-1.61, p = 0.001). Cardiovascular mortality showed a similar trend, however the correlation is not significant. The restricted cubic spline (RCS) showed that the relationship between DII and all-cause and cardiovascular mortality was linear. Subgroup analysis revealed a persistently positive association between DII and all-causemortality across population subgroups. However, an interaction was detected between DII and alcohol history in relation to cardiovascular mortality.

CONCLUSION

DII was positively correlated with the all-cause mortality of ASCVD patients. The intake of a pro-inflammatory diet may increase mortality in ASCVD patients.

Association between dietary selenium intake and severe abdominal aortic calcification in the United States: a cross-sectional study

Abdominal aortic calcification (AAC) is an important predictor of cardiovascular disease. The purpose of the current study was to detect the association between dietary selenium intake and severe AAC. We included 2651 participants from the National Health and Nutrition Examination Survey (NHANES, 2013-2014). Dietary selenium intake was measured using the 24-hour recall method. AAC was quantified using the Kauppila score system based on dual-energy X-ray absorptiometry, with a score of >6 indicating severe AAC. The association between dietary selenium intake and severe AAC was analyzed by using a weighted multivariate logistic regression model, smooth curve fitting, and stratified subgroup analysis. After adjusting for multiple covariates, we found that higher dietary selenium intake was negatively associated with severe AAC incidence. When selenium intake was converted into tertiles, the highest tertile of dietary selenium intake was significantly associated with the incidence of severe AAC (odds ratio = 0.66). Smooth curve fitting revealed that this relationship was nonlinear. Subgroup analysis revealed that this negative association was present in participants with chronic kidney disease, but was absent when participants had hypertension or diabetes mellitus. Higher dietary selenium intake was negatively associated with severe AAC incidence in a nonlinear pattern, except in participants with diabetes mellitus or hypertension. However, further cohort studies are required to validate these findings.

Correlation between dietary inflammation and mortality among hyperlipidemics

BACKGROUND AND OBJECTIVE

Although the the Dietary Inflammatory Index (DII) serves to be one of the reliable indicator for hyperlipidaemia, there is still uncertainty about its relationship to prognosis in the hyperlipidaemic population. In current study, the DII levels were analyzed in relation to the mortality risk among among the hyperlipidaemic individuals with the aim of determining any prospective correlation.

METHODS

14,460 subjects with hyperlipidaemia from the 10-year (2001-2010) National Health and Nutrition Examination Survey (NHANES) were chosen for this study. The endpoint event for follow-up was all-cause mortality, and subjects were tracked for up to December 31, 2019, or death, whichever occurred first. The tertiles of the DII levels were utilized for categorizing the study population into three groups. Survival curves, Cox proportional hazards regression models, restricted cubic spline (RCS), subgroup and interaction analyses, and sensitivity analyses were employed sequentially for the purpose of evaluating the association of the DII with mortality.

RESULTS

3170 (21.92%) all-cause deaths were recorded during an average 148-month follow-up period. Kaplan-Meier survival curves indicated that the survival rate of participants divided into the low DII group was substantially improved compared to that of those in the higher DII group (log-rank P < 0.001). After controlling for confounders, higher levels of DII were observed to be meaningfully linked to an elevated risk of death, no matter whether DII was specified for the continuous (hazard ratio (HR): 1.06; 95% confidence interval (CI): 1.04-1.08) or the categorical variable (HR: 1.22; 95% CI: 1.11-1.33). The DII and mortality displayed a linear association, according to the RCS. Stratified and sensitivity analyses reinforced the proof that these findings were reliable.

CONCLUSION

Among patients with hyperlipidaemia, the risk of death was positively and linearly linked with DII levels.

Relationship between serum uric acid and hypertension in the general US population aged 20 years and older: A cross-sectional study based on NHANES 2007 to 2016

The aim of this study was to investigate the association between serum uric acid (UA) levels and hypertension in American individuals 20 years of age and older. We used continuous cross-sectional surveys from the National Health and Nutrition Examination Survey in the United States from 2007 to 2016. Our selected population was adults aged 20 years and older in the United States. We examined the association between serum UA and risk of hypertension using weighted univariate logistic regression analysis, weighted multivariate logistic regression analysis, weighted subgroup analysis, and weighted restricted cubic spline analysis. Serum UA was significantly linked with hypertension in a multivariate logistic regression model adjusted for all variables (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.15-1.28, P < .001). Furthermore, dividing serum UA into quartiles (Q) revealed an association between elevated serum UA and increased risk of hypertension [Q1 = (OR: 1.00), Q2 = (OR: 1.13, 95% CI: 0.95-1.37, P = .159), Q3 = OR: 1.30, 95% CI: 1.10-1.52, P = .002), Q4 = OR: 1.94, 95% CI: 1.58-2.38, P = .161). Additionally, we conducted subgroup analyses for age, sex, race, education, marital status, diabetes status, smoking, and alcohol use and discovered that these factors had a moderating effect on serum UA and hypertension (P < .05). Last but not least, we looked into the nonlinear link between serum UA and hypertension using weighted restricted cubic splines and discovered that there was no such relationship. The segmental effect of serum UA and hypertension, with an inflection point of 5.079 (mg/dL), was discovered in our gender-stratified study. And in analyses stratified by race and marital status, we similarly found a dose-response relationship between UA and hypertension among Hispanics and unmarried people. Our study showed a positive correlation between serum UA and hypertension.

Dietary inflammatory potential is associated with sarcopenia in patients with hypertension: national health and nutrition examination study

Background

Study has shown that sarcopenia increases the risk of poor outcomes in patients with hypertension. Inflammation is one of the important reasons for the occurrence and development of sarcopenia. Regulating systemic inflammation may be a potential intervention for sarcopenia in hypertensive patients. Diet is one of the important measures to improve systemic inflammation. The dietary inflammatory index (DII) is a tool designed to assess the inflammatory potential of the diet, the association between DII and sarcopenia in hypertensive patients is unclear.

Objective

To explore the relationship between the DII and sarcopenia in patients with hypertension.

Method

Data from the National Health and Nutrition Examination Survey (NHANES) 1999-2006 and 2011-2018. A total of 7,829 participants were evaluated. Participants were divided into four groups based on the quartile of the DII: Q1 group (n = 1,958), Q2 group (n = 1,956), Q3 group (n = 1,958) and Q4 group (n = 1,957). The relationship between the DII and sarcopenia was assessed by logistic regression analysis based on the NHANES recommended weights.

Result

The DII was significantly associated with sarcopenia in patients with hypertension. After full adjustment, patients with higher DII (OR: 1.22, 95% CI: 1.13-1.32, p < 0.001) have a higher risk of sarcopenia. Compared with Q1 group, the group with higher DII levels had a higher risk of sarcopenia (Q2: OR: 1.23, 95%CI: 0.89-1.72, p = 0.209; Q3: OR: 1.68, 95%CI: 1.20-2.35, p = 0.003; Q4: OR: 2.43, 95%CI: 1.74-3.39, p < 0.001).

Conclusion

High DII is associated with an increased risk of sarcopenia in hypertensive patients. The higher the level of DII, the higher the risk of sarcopenia in hypertensive patients.