Dietary Inflammatory Index and Its Association with the Prevalence of Coronary Heart Disease among 45,306 US Adults

A nonlinear relationship between dietary inflammatory index and stroke among US adults with metabolic dysfunction-associated steatotic liver disease

BACKGROUND

Some studies have found that high dietary inflammatory index (DII) increases stroke risk, but previous studies have mostly been conducted in the general population, and the exact relationship between DII and stroke in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is not clear.

METHODS

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2009-2016) to investigate the association between the DII and stroke. DII was computed according to established methods. Participants were categorized into tertiles of DII (Q1-Q3). Multivariate weighted logistic regression analysis, smooth curve fitting, and subgroup analysis were employed to explore this relationship. Subgroup analyses were conducted based on demographic and clinical variables.

RESULTS

A total of 2426 individuals were enrolled in our study. The overall prevalence of stroke in the study population was 4.66%. The smooth curve fitting analysis indicated a J-shaped relationship between DII and stroke among individuals with MASLD. In multivariate weighted logistic regression analysis, the odds ratio (OR) of DII is 1.17 (95% CI: 1.03-1.38) for stroke, with a turning point of 1.89. After the turning point, the OR (95% CI) was 1.22 (1.08-2.56). In subgroup analysis, DII still increased the risk of stroke independently.

CONCLUSION

Our study highlighted a J-shaped association between DII and stroke in adults with MASLD from USA.

Polygenic risk score, dietary inflammatory potential, and incident coronary heart disease

AIMS

Dietary inflammatory potential and genetic factors are reported as being linked to coronary heart disease (CHD). We aimed to investigate their joint association with CHD incidence.

METHODS AND RESULTS

We included 51 889 British participants from the UK Biobank who completed the 24-h dietary assessment at baseline. We used reduced rank regression and stepwise linear regression analyses to generate an empirical dietary inflammatory pattern (EDIP) score to assess dietary inflammatory potential. A polygenic risk score (PRS) for CHD was constructed based on 1.7 million genetic variants. During a median follow-up of 11 years, 1346 incident cases of CHD were observed. High EDIP scores significantly increased the risk of CHD with the hazard ratio (HR) [95% confidence interval (CI)] of 1.26 (1.10-1.45) for high EDIP scores (T3) compared with low EDIP scores (T1). Interestingly, we observed a gradient in the risk of CHD across PRS categories, with the HRs of 1.12 (95% CI: 0.73-1.71), 1.20 (95% CI: 1.01-1.43), and 1.42 (95% CI: 1.10-1.83) in low (Q1), intermediate (Q2-4), and high (Q5) PRS categories, respectively. When the joint effect was examined, individuals with high PRS (Q5) and high EDIP scores (T3) would have the highest risk of CHD with a HR of 3.87 (95% CI: 2.74-5.46) compared with individuals with both low PRS (Q1) and low EDIP scores.

CONCLUSION

High dietary inflammatory potential was associated with a higher CHD risk, especially in those with high PRS, suggesting that a comprehensive assessment of inflammatory diet and genetic factors may be beneficial in the prevention of CHD.

Associations of dietary inflammation index and composite dietary antioxidant index with all-cause mortality in COPD patients

Background

Few studies have investigated the effects of both dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) on mortality in patients with Chronic Obstructive Pulmonary Disease (COPD). Our research aimed to explore the associations between the two indicators with all-cause mortality in COPD patients.

Methods

We conducted a prospective cohort analysis based on data from the six cycles of the National Health and Nutrition Examination Survey (NHANES) dataset from 2007 to 2018. Multivariate Cox proportional hazard models were used to analyze the effects of DII and CDAI on all-cause mortality in COPD. We employed restricted cubic spline (RCS) analysis to examine the dose-response relationship between two indicators and all-cause mortality, used threshold effect analysis to determine the inflection point, and conducted subgroup analysis and interaction tests to verify the stability of the results.

Results

A total of 1,457 COPD patients aged over 40 were enrolled in the study. The median follow-up time was 76.8 months. The multivariate Cox proportional hazards model showed that increased DII was associated with an increase in all-cause mortality (HR (95% CI): 1.11(1.04, 1.18), p = 0.002). In contrast, CDAI was negatively correlated with all-cause mortality (HR (95% CI): 0.95(0.91, 0.99), p = 0.01). The RCS analysis showed a nonlinear correlation between DII or CDAI and all-cause mortality. The maximum pro-inflammatory inflection point of DII was 2.32, while the antioxidant threshold of CDAI is -0.12. Subgroup analyses indicated that the relationship between exposure variables and all-cause mortality was stable in most populations.

Conclusion

Reducing the pro-inflammatory diet or increasing the antioxidant diet can reduce all-cause mortality in COPD patients.

Association between chest pain and risk of depression in patients with or without coronary heart disease

BACKGROUND

Research on the relationship between chest pain and depression risk in patients with or without coronary heart disease (CHD) is limited.

METHODS

This cross-sectional study includes adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. The diagnoses of chest pain and CHD were based on self-reports from participants, while depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). The study employs logistic regression, subgroup analysis, and sensitivity analysis to explore the association between chest pain and depressive symptoms, taking into account the influence of CHD.

RESULTS

The study included 15,048 adults aged 20 years or older, with an average age of 59.6 ± 12.1 years, and 51.6 % were male. After adjusting for covariates, a significant difference in the association between chest pain and the risk of depression was observed between the non-CHD group and CHD group (non-CHD group: OR = 2.43, 95 % CI: 2.13-2.78; CHD group: OR = 1.2, 95 % CI: 0.72-1.98). Furthermore, subgroup analysis revealed an interaction between CHD status and chest pain that may reduce the prevalence of depression (P-value for interaction = 0.004). Sensitivity analysis confirmed the stability of the results.

CONCLUSION

Our findings suggest that the presence of CHD may influence the relationship between chest pain and depression risk among American adults. His conclusion requires further validation through randomized controlled trials.

Association of the newly proposed dietary index for gut microbiota and constipation: a cross-sectional study from NHANES

Objective

The dietary index for gut microbiota. DI-GM is an innovative metric designed to capture the diversity of the gut microbiome, yet its association with constipation remains unstudied.

Methods

In this cross-sectional study, 11,405 adults aged 20 and older were selected from the National Health and Nutrition Examination Survey 2005-2010 for the sample. Constipation was defined as fewer than three defecation frequencies per week using bowel health questionnaire (BHQ). Fewer than three bowel movements per week were considered as constipation by Bowel Health Questionnaire (BHQ). DI-GM was derived from dietary recall data, including avocado, broccoli, chickpeas, coffee, cranberries, fermented dairy, fiber, green tea, soybean and whole grains as beneficial elements, red meat, processed meat, refined grains, and high fat as detrimental components. Multivariable weighted logistic was employed to investigate the association of DI-GM with constipation. Secondary analyses included subgroup analyses, restricted cubic spline (RCS), and multiple imputation.

Results

A higher DI-GM and beneficial gut microbiota score were associated with a lower prevalence of constipation (DI-GM: OR = 0.82, 95% CI = 0.75, 0.90; beneficial gut microbiota score: OR = 0.77, 95% CI = 0.67, 0.89). After grouping DI-GM, in the fully adjusted model, participants with DI-GM ≥ 6 were significantly negatively correlated with both the prevalence of constipation (OR = 0.48, 95% CI = 0.33, 0.71). RCS indicated a non-linear relationship between DI-GM and constipation. Subgroup analyses by age, sex and common complications showed no statistically significant interactions (p > 0.05).

Conclusion

The newly proposed DI-GM was inversely related with the prevalence of constipation. When treating patients with constipation, it is necessary for clinicians to provide timely and effective dietary interventions incorporating the DI-GM for patients with constipation to avoid further deterioration of the condition.

L-shaped association of dietary inflammatory index (DII) and chronic diarrhea: results from NHANES 2005-2010

BACKGROUND

Since diet is a known modulator of inflammation, the Dietary Inflammatory Index (DII), which quantifies the inflammatory potential of an individual's diet, becomes a significant parameter to consider. Chronic diarrhea is commonly linked to inflammatory processes within the gut. Thus, this study aimed to explore the potential link between DII and chronic diarrhea.

METHODS

This research utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. The DII was calculated according to the average intake of 28 nutrients using information gathered from two 24-hour recall interviews. The Bristol Stool Form Scale (BSFS) was adopted to describe chronic diarrhea, identifying stool Type 6 and Type 7. Multivariate logistic regression models examined the causal connection between DII and chronic diarrhea. Additionally, subgroup analyses and interaction tests were conducted.

RESULTS

The study encompassed 11,219 adults, among whom 7.45% reported chronic diarrhea. Initially, multivariate logistic regression analysis revealed a positive association between DII and chronic diarrhea. Nevertheless, this connection lost statistical significance (OR = 1.00; 95% CI, 0.96-1.05; P = 0.8501) after adjusting for all confounding variables. Stratified by sex, the analysis revealed a notable rise in the risk of chronic diarrhea with increasing DII among female participants (all P for trend < 0.05). This tendency remained constant even after full adjustment (P for trend = 0.0192), whereas no significant association was noted in males (all P for trend > 0.05). Furthermore, an L-shaped association emerged between DII and chronic diarrhea, with an inflection point of -1.34. In the population with DII scores below -1.34, each unit increase in DII correlated with a 27% reduction in the probability of chronic diarrhea (OR = 0.73; 95% CI, 0.57-0.93), whereas in the population with DII scores above -1.34, the risk increased by 4% (OR = 1.04; 95% CI, 0.98-1.10). Merely, the gender interaction was shown to be statistically significant based on subgroup analyses and interaction tests.

CONCLUSIONS

A favorable association between DII and chronic diarrhea exists in adults in the United States. Nevertheless, additional long-term prospective studies are required to confirm and solidify those findings.

The Association Between the Dietary Inflammatory Index, Dietary Pattern, and Hypertension Among Residents in the Xinjiang Region

Background: Diet and inflammation are both associated with hypertension. We aimed to investigate the relationship between the dietary inflammation index (DII), dietary patterns, and the risk of hypertension among Xinjiang residents. Methods: A total of 930 residents aged 20-80 from Shihezi and Tumushuk were selected as participants using a stratified whole cluster random sampling method. General demographic information, dietary data, and physical examination results were collected from the participants and DII scores were calculated. Restricted cubic spline was used to analyze the dose-response relationship between the DII and the risk of hypertension. LASSO regression was used to screen dietary factors associated with hypertension. Factor analysis was used to extract dietary patterns. Finally, logistic regression modeling was used to analyze the association between the DII, dietary patterns, and the risk of hypertension. Results: The DII was linearly and positively associated with the risk of developing hypertension. Logistic regression analysis showed that the prevalence of hypertension was 2.23 (95% CI: 1.53, 3.23) and 3.29 (95% CI: 2.26, 4.79) in the T2 and T3 groups, respectively, compared with the T1 group. Riboflavin and folate were associated with the risk of hypertension. In the vegetable-egg dietary pattern, the risk of hypertension was reduced by 33%, 39%, and 37% in groups Q2, Q3, and Q4, respectively, compared with group Q1 (Q2: OR = 0.67, 95% CI: 0.45, 0.99; Q3: OR = 0.61, 95% CI: 0.41, 0.92; Q4: OR = 0.63, 95% CI: 0.42, 0.96). Conclusions: The higher the DII score, the higher the risk of hypertension among residents of Xinjiang. In addition, vegetable-egg dietary patterns can reduce the risk of hypertension. Therefore, local residents should be scientifically instructed to increase their intake of vegetables and eggs.

Macrophage metabolic reprogramming: A trigger for cardiac damage in autoimmune diseases

Macrophage metabolic reprogramming has a central role in the progression of autoimmune and auto-inflammatory diseases. The heart is a major target organ in many autoimmune conditions and can sustain functional and structural impairments, potentially leading to irreversible cardiac damage. There is mounting clinical evidence pointing to a link between autoimmune disease and cardiac damage. However, this association remains poorly understood, and numerous patients do not receive appropriate preventive measures, which poses serious cardiovascular risks and significantly impacts their quality of life. This review discusses the relationship between macrophage metabolic reprogramming and cardiac damage in patients with autoimmune diseases and the role of adaptive immunity in macrophage reprogramming. It also provides an overview of the immunosuppressive therapies used at present. Exploiting the properties of macrophage reprogramming could lead to development of novel treatments for patients with autoimmune-related cardiac damage.

Associations of dietary riboflavin intake with coronary heart disease in US adults: a cross-sectional study of NHANES 2007-2018

Objective

There is currently little study on the relationship between dietary riboflavin intake and coronary heart disease (CHD) risk.

Methods

Using information from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, we carried out a cross-sectional study. Dietary riboflavin intake and CHD risk were examined using weighted univariate and multivariable logistic regression. To learn more about the connection between dietary riboflavin intake and CHD risk, subgroup analyses and interactions were conducted. Next, the potential non-linear association was visually described using restricted cubic spline (RCS).

Results

The risk of CHD was inversely correlated with dietary riboflavin consumption. The multivariable odds ratio (OR) with 95% confidence interval (CI) for the risk of CHD was 0.52 (95%Cl: 0.34-0.81, Ptrend = 0.009) for the highest vs. lowest tertiles of riboflavin. This protective effect of dietary riboflavin on CHD was influenced by gender, drinking status and serum folate concentration. A non-linear inverse connection (Pfor nonlinearity ≤ 0.001) was shown using RCS analysis between riboflavin intake and the risk of CHD.

Conclusion

Our research suggested that consuming more riboflavin in your diet may lessen the risk of CHD. The results improved the current knowledge base and supplied potential implications for dietary recommendations and health policy.

Screening and regulatory mechanism exploration of M1 macrophage polarization and efferocytosis-related biomarkers in coronary heart disease

Background

Macrophage polarization and efferocytosis have been implicated in CHD. However, the underlying mechanisms remain elusive. This study aimed to identify CHD-associated biomarkers using transcriptomic data.

Methods

This study examined 74 efferocytosis-related genes (ERGs) and 17 M1 macrophage polarization-related genes (MRGs) across two CHD-relevant datasets, GSE113079 and GSE42148. Differential expression analysis was performed separately on each dataset to identify differentially expressed genes (DEGs1 and DEGs2). The intersection of upregulated and downregulated genes from both sets was then used to define the final DEGs. Subsequently, MRG and ERG scores were calculated within the GSE113079 dataset, followed by weighted gene co-expression network analysis (WGCNA) to identify key module genes. The overlap between these module genes and the DEGs yielded candidate biomarkers, which were further evaluated through machine learning, receiver operating characteristic (ROC) curve analysis, and expression profiling. These biomarkers were subsequently leveraged to explore immune infiltration patterns and to construct a molecular regulatory network. To further validate their expression, quantitative reverse transcriptase PCR (qRT-PCR) was performed on clinical CHD samples, confirming the relevance and expression patterns of these biomarkers in the disease.

Results

A total of 93 DEGs were identified by intersecting the upregulated and downregulated genes from DEGs1 and DEGs2. WGCNA of the MRG and ERG scores identified 15,936 key module genes in the GSE113079 dataset. Machine learning and ROC analysis highlighted four biomarkers: C5orf58, CTAG1A, ZNF180, and IL13RA1. Among these, C5orf58, and ZNF180 were downregulated in CHD cases, while CTAG1A and IL13RA1 was upregulated. qRT-PCR results validated these findings for C5orf58, CTAG1A, ZNF180, and IL13RA1 showed inconsistent expression trends. Immune infiltration analysis indicated IL13RA1 all had a positive correlation with M0 macrophage, while had a negative correlation with. NK cells activated. The molecular regulatory network displayed that GATA2 and YY1 could regulate CTAG1A and ZNF180.

Conclusions

These results suggest that C5orf58, CTAG1A, ZNF180, and IL13RA1 serve as biomarkers linking M1 macrophage polarization and efferocytosis to CHD, providing valuable insights for CHD diagnosis and therapeutic strategies.

The Relationship of Certain Diseases and Dietary Inflammatory Index in Older Adults: A Narrative Review

PURPOSE OF REVIEW

One of the important markers affecting aging processes is the increase in inflammatory markers. Many chronic diseases are associated with inflammation and chronic inflammation increases with aging. Inflammation can change with dietary components. Foods, compounds and nutrients that have anti-inflammatory or proinflammatory properties attract attention. According to the Dietary Inflammatory Index, positive scores are obtained if the nutrient has a proinflammatory effect on cytokines, and negative scores are obtained if it has an anti-inflammatory effect.

RECENT FINDINGS

A higher proinflammatory diet is associated with cardiometabolic diseases, neurodegenerative disease, cancers and musculoskeletal health and related mortality. In this study, its relationship with type 2 diabetes mellitus, obesity, metabolic syndrome, musculoskeletal diseases, dementia, depression and cancer, which are more common in older adults and known to be associated with inflammation, was examined. Although studies involving under 65 years old are more prevalent, research involving older adults and Dietary Inflammatory Index (DII) is more limited. It is known that chronic inflammation increases with aging. Diet is one of the factors affecting inflammation. In the light of these investigations, the topics of anti-inflammatory nutrition and DII for the treatment of inflammation-related diseases in older adults are strong and open to development topics of discussion. Despite the significant interest in the potential positive effects of anti-inflammatory nutrition on diseases, contributing to clearer evidence of its protective effects on health necessitates further randomized controlled trials, in vivo, in vitro, cell, animal, human and case-control studies for better risk assessment.

The dietary inflammatory index and asthma prevalence: a cross-sectional analysis from NHANES

Background

Inflammation is a key factor in the development of asthma, and diet significantly influences inflammatory responses. This study examines the relationship between the Dietary Inflammatory Index (DII) and asthma prevalence.

Methods

We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Demographic details, anthropometric measurements, dietary habits, lifestyle factors, and asthma status were recorded for all participants. Multivariable logistic regression was utilized to assess the relationship between DII and asthma prevalence. Additionally, restricted cubic spline (RCS) analysis was employed to explore the nonlinearity and dose-response relationship between DII and asthma risk. Subgroup analyses were stratified by gender, age, race, body mass index (BMI), poverty income ratio (PIR), education, smoking status, alcohol use, and family medical history to dissect the association between DII and asthma across diverse populations.

Results

The analysis included 37,283 adults from NHANES. After adjusting for potential confounders in the multivariable logistic regression model, a significant positive association was identified between DII and asthma (OR, 95% CI: 1.05, 1.02-1.09, per 1 SD increase). The RCS analysis revealed a nonlinear association (p for nonlinearity = 0.0026), with an inflection point at 1.366, beyond which an increase in DII was significantly associated with asthma risk. Furthermore, the stratified analyses indicated a positive association between DII and asthma in the majority of subgroups.

Conclusion

The findings underscore a significant and nonlinear association between DII and asthma. To enhance asthma prevention and management, greater emphasis should be placed on modulating dietary-induced inflammation.

Dietary inflammatory index as a predictor of prediabetes in women with previous gestational diabetes mellitus

INTRODUCTION

Gestational diabetes mellitus (GDM) is associated with an increased risk of developing type 2 diabetes mellitus (T2DM). The inflammatory potential of diet is crucial in GDM development. This study compares dietary inflammatory indices (DII) in females with and without a history of GDM and constructs a predictive model for prediabetes risk.

METHODS

Cross-sectional data from NHANES cycles (2011-2014) were analyzed using the DII. Independent t tests, chi-square test, and Mann-Whitney U test examined DII scores in relation to GDM history. Multivariate logistic regression assessed DII's association with prediabetes in females with GDM history. Restricted cubic spline (RCS) and LASSO regression modeled non-linear relationships and predicted prediabetes risk.

RESULTS

971 female participants were included. Those with GDM history had lower DII scores (1.62 (0.58, 2.93) vs. 2.05 (0.91, 2.93)). Higher DII scores in females with GDM were linked to prediabetes, remaining significant after adjusting for confounders. RCS analysis found no non-linear correlation (non-linear p = 0.617). The prediabetes model for GDM history had strong predictive performance (AUC = 88.6%, 95% CI: 79.9-97.4%).

CONCLUSION

Females with GDM history show lower DII levels, potentially reflecting improved diet and health awareness. Higher DII scores correlate with increased prediabetes risk in this group, emphasizing diet's role in diabetes risk. Further studies are needed to confirm these findings.

Carnitine is a friend in HFpEF and foe in HFrEF

Heart failure (HF) is a global concern, particularly HF with preserved ejection fraction (HFpEF), lacking effective treatments. Understanding the differences of metabolic profiles between HFpEF and HFrEF (heart failure with reduced ejection fraction) patients is crucial for therapeutic advancements. In this study, pseudotargeted metabolomics was employed to analyze for disparities of plasma metabolic profiles between HFpEF and HFrEF in two cohorts: discovery (n = 514) and validation (n = 3368). Plasma-free carnitine levels were significant changed in HF patients. A non-linear and U-shaped (for HFpEF) or J-shaped (for HFrEF) association between circulating free carnitine levels and the composite risk of cardiac events were observed. Interestingly, HFpEF patients with low free carnitine (≤40.18 μmol/L) displayed a poorer survival, contrasting with HFrEF where higher levels (≥35.67 μmol/L) were linked to poorer outcomes, indicating distinct metabolism pathways. In conclusion, these findings offer insights into HFpEF metabolic profiles, suggesting potential therapeutic targets.

Dietary antioxidant and inflammatory potential in asthmatic patients and its association with all-cause mortality

BACKGROUND

The occurrence and progression of asthma can be influenced by the components in food. Our study aims to determine whether dietary antioxidant and inflammatory potential are associated with the risk of mortality in asthma patients.

METHODS

Participants from the 2001-2018 National Health and Nutrition Examination Survey (NHANES) aged 20 years and older with a diagnosis of asthma were included. Mortality status was obtained according to death certificate records from the National Death Index. The antioxidant and inflammatory potential of the diet was assessed using two widely used and dependable indices, Composite Dietary Antioxidant Index (CDAI) and Dietary Inflammatory Index (DII). Restricted cubic spline (RCS) regression was used to analyze the non-linear relationship between the two indexes and mortality. Multivariable Cox proportional risk models were used to estimate hazard ratio and 95% confidence intervals for mortality. Finally, the relationship between CDAI and DII was analyzed.

RESULTS

A total of 4698 NHANES participants represented 23.2 million non-institutionalized residents of the US were enrolled in our study. Patients with higher CDAI or lower DII exhibited longer survival times. RCS regression showed a linear relationship of CDAI or DII with mortality. In the Cox regression, both crude and adjusted models demonstrated that higher CDAI or lower DII was linked to a reduced risk of all-cause mortality. Similar associations were found in subgroup analysis. Finally, a negative relationship was found between CDAI and DII.

CONCLUSION

Reducing pro-inflammatory or increasing antioxidant diets could reduce all-cause mortality among adult asthma patients.

Association Between the Inflammatory Potential of Diet and Constipation Among Adults in the United States: A Cross-sectional Study

OBJECTIVE

To investigate the potential association between Dietary Inflammatory Index (DII) scores and constipation among a sample of adults in the United States.

METHODS

This cross-sectional study used data from adult participants in the 2005 to 2010 National Health and Nutrition Examination Survey (ie, "NHANES"). Self-reported information was used to identify cases of constipation. The DII was used to assess inflammatory potential of the diet. Odds ratios (ORs) and corresponding 95% CIs for the association between the DII and constipation were determined using multivariate logistic regression modeling. Stratified analyses explored whether there was effect modification to influence the relationship between DII and constipation.

RESULTS

Of 8272 subjects, 759 reported constipation, and 7513 did not, corresponding to a prevalence of 9.2%. After adjusting for age, gender, race/ethnicity, marital status, education level, smoking status, alcohol consumption, physical activity, body mass index (BMI), cardiovascular diseases (CVD), hypertension, stroke, diabetes, energy intake, carbohydrate intake, and selective serotonin reuptake inhibitor (SSRI) use. Compared with lower DII scores group T1 (-5.28 to ≤0.72), the adjusted OR values for DII scores and constipation in T2 (>0.72 to ≤2.50) and T3 (>2.50 to 5.24) were 1.27 (95% CI: 1.02-1.58, P=0.029) and 1.43(95% CI: 1.14-1.8, P=0.002). Subgroup analyses showed that there were effect modification of gender and physical activity factors on DII scores and constipation.

CONCLUSIONS

Results of this cross-sectional study suggest that a higher dietary inflammatory index score was associated with increased risk of constipation after adjustment for confounding in a multivariable analysis. gender and physical activity were found to be an effect modifier of this relationship.

The relationship between system inflammation response index and coronary heart disease: a cross-sectional study (NHANES 2007-2016)

Background

Coronary heart disease (CHD) is one of the common chronic diseases in clinical practice, often accompanied by inflammatory reactions. In recent years, the system inflammation response index (SIRI) has aroused researchers' interest as a novel inflammatory biomarker. This study aims to explore the relationship between the SIRI and CHD through the National Health and Nutrition Examination Survey (NHANES) database.

Methods

We conducted a cross-sectional study and analyzed participants aged 40 and above with complete data from the NHANES survey years 2007-2016. Logistic regression analysis was used in this study to explore the relationship between the risk of CHD and SIRI. Stratified subgroup analysis was conducted based on age, gender, race, education level, body mass index (BMI), smoking status, drinking, hypertension, diabetes and angina pectoris to evaluate the relationship between SIRI and CHD in different populations. Additionally, restricted cubic spline (RCS) analysis was employed to investigate whether there is a nonlinear association between SIRI and CHD.

Results

A total of 6374 eligible participants were included, among whom 387 were diagnosed with CHD. The SIRI levels in the CHD group were significantly higher than those in the non-CHD group. After adjusting for potential confounders, an elevated SIRI level was associated with an increased risk of CHD, with an odds ratio of 1.12, 95% CI: (1.03, 1.22), P = 0.008. Subgroup analysis results indicated a significant interaction between SIRI and CHD among genders (P for interaction <0.05), especially in females. In contrast, no significant interaction was observed among age, race, education level, BMI, smoking status, drinking, hypertension, diabetes and angina pectoris (P for interaction >0.05). The RCS analysis showed a significant linear relationship between SIRI and CHD (P for non-linearity >0.05), with an inflection point at 2.86.

Conclusion

Our study indicates that an elevated system inflammation response index is associated with a higher risk of CHD. Particularly among women.

Dietary inflammatory index is associated with severe depression in older adults with stroke: a cross-sectional study

Inflammation is involved in the pathogenesis of stroke and depression. We aimed to investigate the association between the dietary inflammatory index (DII) and depression in American adults with stroke. Adults with stroke were enrolled in the National Health and Nutrition Examination Survey between 2005 and 2018 in the USA. The DII was obtained from a 24-h dietary recall interview for each individual. Multivariate regression and restricted cubic spline analyses were conducted to evaluate the association between DII and depression in adults with stroke. The mean age of the 1239 participants was 63·85 years (50·20 % women), and the prevalence of depression was 18·26 %. DII showed a linear and positive association with severe depression in adults with stroke (OR 1·359; 95 % CI 1·021, 1·810; P for non-linearity = 0·493). Compared with those in the lowest tertile of the DII, adults with stroke in the third tertile of the DII had a 3·222-fold higher risk of severe depression (OR 3·222; 95 % CI 1·150, 9·026). In the stratified analyses, the association between DII score and severe depression was more significant in older adults (P for interaction = 0·010) but NS with respect to sex (P for interaction = 0·184) or smoking status (P for interaction = 0·396). No significant association was found between DII and moderate-to-moderately severe depression in adults with stroke. In conclusion, an increase in DII score was associated with a higher likelihood of severe depression in older adults with stroke.

Prevalence of anemia in patients with rheumatoid arthritis and its association with dietary inflammatory index: A population-based study from NHANES 1999 to 2018

Anemia is common in patients with rheumatoid arthritis (RA), and it is unknown whether the dietary inflammatory index (DII) is linked to anemia. This study aimed to clarify the prevalence of anemia in RA patients and its association with the DII. The data utilized in this study were collected from the National Health and Nutrition Examination Survey database from 1999 to 2018. The prevalence of anemia in RA patients was estimated by ethnicity, sex, and age. Weighted multivariate logistic regression was utilized to explore the correlation between anemia risk and DII. The most crucial dietary factors related to the risk of anemia in RA patients were screened by stepwise regression. A nomogram model was established according to key dietary factors. A total of 10.25% (confidence interval, 8.58-11.92%) of RA patients will develop anemia, with the lowest prevalence around the age of 60. In addition, higher DII levels were discovered in anemic patients than in nonanemic patients. In multivariate regression models, an important positive association was revealed between anemia and growing quartiles of DII (Q4 vs Q1: odds ratio = 1.98; confidence interval, 1.25-3.15). In the subgroup analysis, the adjusted relation of DII with anemia in females, Mexicans, smokers, nondrinkers, and age groups ≥ 60 years was statistically significant. The same association was observed in the sensitivity analysis. A nomogram model based on stepwise regression screening of key dietary factors showed good discriminatory power to identify anemic risk in RA patients (area under the curve: 0.707). In patients with RA, high DII levels were associated with the risk of anemia. More attention should be given to controlling dietary inflammation to better prevent and treat anemia.

Association between blood cell ratios and coronary heart disease: A 10-year nationwide study (NHANES 2009-2018)

Blood cell ratios are a standard clinical index for the assessment of inflammation. Although a large number of epidemiological investigations have shown that inflammation is a potential risk factor for the development of coronary heart disease (CHD), there is not sufficient and direct evidence to confirm the relationship between blood cell ratios and CHD. Therefore, this study aimed to elucidate the effect of blood cell ratios on the incidence of coronary heart disease. This 10-year national study included data from 24,924 participants. The independent variable was blood cell ratios, and the dependent variable was coronary heart diseases (yes or no). The relationship between blood cell ratios and coronary heart disease was verified using baseline characteristic analysis, multivariate logistic regression analysis, smoothed fitted curves, and subgroup analysis. This study found that in multiple logistic regression analysis showed significant positive correlation between monocyte counts × meutrophil counts/lymphocyte counts (SIRI) (OR = 1.495; 95% CI = 1.154-1.938), monocyte-lymphocyte ratio (MLR) (OR = 3.081; 95% CI = 1.476-6.433) and the incidence of CHD; lymphocyte-monocyte ratio (LMR) (OR = 0.928;95% CI = 0.873-0.987), monocyte-lymphocyte ratio (PLR) (OR = 0.997;95% CI = 0.994-1.000) showed negative correlation with CHD. The smoothed curve fitting shows a nonlinear relationship between SIRI, LMR, PLR, and CHD, with an inverted U-shaped curve between SIRI and CHD, an L-shaped angle between LMR and CHD, and a U-shaped curve between PLR and CHD, respectively. Their inflection points are 1.462, 3.75, and 185.714, respectively. SIRI has an inverted U-shaped curve with coronary heart disease, suggesting that low levels of SIRI increase the risk of CHD; LMR with an L-shaped curve with CHD, and PLR with a U-shaped curve with CHD, suggesting that the risk of CHD can be prevented when LMR and PLR are reduced to a certain level. This has positive implications for the prevention and treatment of CHD.

Chinese Healthy Eating Index (CHEI) and risk of diabetes in Chinese adults: a prospective cohort study

PURPOSE

The Chinese Healthy Eating Index (CHEI) is a valid instrument to assess the diet quality of the Chinese population, but evidence regarding the relationship between CHEI and the risk of diabetes remains limited. We aimed to investigate the prospective association of CHEI with diabetes among Chinese adults.

METHODS

1563 adults free of diabetes at baseline and with at least two survey data from 1997 to 2018 were included. Dietary information was collected by three consecutive 24-h recalls combined with household food inventory, and long-term diet quality was evaluated by the CHEI. Diabetes was defined as self-reported physician-diagnosed diabetes and/or fasting blood glucose ≥ 7.0 mmol/L, and/or HbA1c ≥ 6.5%. Cox proportional hazard models and restricted cubic spline analysis were used to estimate the associations between CHEI and diabetes.

RESULTS

During a median follow-up of 12.0 years, 192 (10.3%) participants developed new-onset diabetes. Generally, a five-point higher CHEI score was significantly associated with a 17% lower risk of diabetes (HR, 0.83; 95%CI 0.71-0.97). In stratified analysis, inverse associations between CHEI and diabetes were more vigorous in females (HR, 0.68; 95%CI 0.54-0.85) than in males (P for interaction = 0.01). In addition, there was an L-shaped association between CHEI and diabetes risk in the whole population (P for non-linearity = 0.026), while no significant non-linear association was observed in females or males, respectively.

CONCLUSION

Our results suggested that a long-term higher-quality diet evaluated by CHEI was significantly associated with lower risks of diabetes, and the favorable associations were more pronounced among females.

Dietary inflammatory index is associated with metabolic dysfunction-associated fatty liver disease among United States adults

Background

Metabolic dysfunction-associated fatty liver disease (MAFLD) is presently the most prevalent chronic liver disorder globally that is closely linked to obesity, dyslipidemia metabolic syndrome, and type 2 diabetes mellitus (T2DM). Its pathogenesis is strongly associated with inflammation, and diet is a major factor in reducing inflammation. However, current research has focused primarily on exploring the relationship between diet and NAFLD, with less research on its link to MAFLD.

Methods

In this research, using dietary inflammatory index (DII) as a measure to assess dietary quality, we analyzed the relationship between diet and MAFLD. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including 3,633 adults with complete DII and MAFLD, were used to develop cross-sectional analyses. Logistic regression analysis was adapted for investigating the relationship between DII and MAFLD development. Additionally, subgroup analysis and threshold effect analysis were carried out.

Results

A positive link between DII and MAFLD was found in the fully adjusted model (OR = 1.05; 95%CI, 1.00-1.11, p < 0.05). Subgroup analysis indicated that there was no significant dependence for the connection between DII and MAFLD except for the subgroup stratified by age. Compared with other age groups, people with MAFLD had 20% higher DII scores than non-MAFLD participants in those aged 20-41 years old (OR = 1.20; 95%CI, 1.08-1.33, p < 0.001). Furthermore, we found a U-shaped curve with an inflection point of 3.06 illustrating the non-linear connection between DII and MAFLD.

Conclusion

As a result, our research indicates that pro-inflammatory diet may increase the chance of MAFLD development, thus improved dietary patterns as a lifestyle intervention is an important strategy to decrease the incidence of MAFLD.

Association of composite dietary antioxidant index with prevalence of stroke: insights from NHANES 1999-2018

Background

There is a growing acknowledgment of the potential influence of antioxidative effects resulting from dietary decisions on the occurrence of stroke. The objective of this study was to elucidate the correlation between the composite dietary antioxidant index (CDAI) and the incidence of stroke in the general population of the United States.

Methods

We gathered cross-sectional data encompassing 40,320 participants from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999 to 2018. Employing weighted multivariate logistic regression, we assessed the correlation between CDAI and stroke, while also investigating potential nonlinear relationships through restricted cubic spline (RCS) regression. Further, the intake of CDAI components were then incorporated into a predictive nomogram model, subsequently evaluated for its discriminatory prowess in stroke risk assessment using the receiver operating characteristic (ROC) curve.

Results

Post-adjustment for confounding variables, we found that higher CDAI score were associated with a decreased risk of stroke, the odds ratio (OR) [95% CI] of CDAI associating with prevalence was 0.96 [0.94-0.98] (P< 0.001). Moreover, the adjusted OR [95% CI] for stroke across ascending CDAI quartiles stood at 0.90 [0.74-1.09], 0.74 [0.60-0.91], and 0.61 [0.50-0.76] compared to the reference quartile, respectively. The RCS analysis indicated a nonlinear yet negative correlation between CDAI and stroke. The nomogram model, constructed based the intake of antioxidants, exhibited a significant predictive capacity for stroke risk, boasting an area under the curve (AUC) of 77.4% (76.3%-78.5%).

Conclusion

Our investigation ascertained a nonlinear negative relationship between CDAI and stroke within the broader American population. However, given the inherent limitations of the cross-sectional design, further comprehensive research is imperative to establish the causative nature of this association.

Association of dietary inflammatory index with constipation: Evidence from the National Health and Nutrition Examination Survey

The association of dietary inflammatory index (DII) with constipation has not been well studied in general population. Therefore, the aim of this cross-sectional study was to investigate whether DII is associated with constipation in a large representative sample of the US population. Data were obtained from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). A total of 12,308 participants aged ≥20 years were included in the analysis. DII was calculated based on a single 24-h dietary recall, and constipation was defined as having fewer than three bowel movements per week by the questionnaire on bowel health. Logistic regression analysis demonstrated a significant positive association between DII score and constipation, with each unit increase in DII score associated with a 20% increase in constipation risk (95% CI: 1.13-1.28). Subgroup analysis revealed high odds ratios (ORs) among individuals classified as "Other Race" (OR: 1.42, 95% CI: 1.12-1.80) and "Non-Hispanic White" (OR: 1.31, 95% CI: 1.12-1.54). In addition, RCS analysis indicated a nonlinear relationship between DII and constipation among individuals with a BMI less than 25 (OR: 1.17, 95% CI: 1.07-1.28), while the overall trend remained positive correlation (OR: 1.20, 95% CI: 1.10-1.31). Briefly, our study suggests that there may be a link between DII and constipation, which has implications for the development of dietary interventions aimed at preventing and managing constipation. However, this association was complex and variable depending on individual factors such as BMI and racial background and needed to establish longitudinal studies to confirm the underlying mechanisms between DII and constipation.

Gender differences in the association between healthy eating index-2015 and hypertension in the US population: evidence from NHANES 1999-2018

BACKGROUND

Diet has long been recognized as an important modifiable risk factor for hypertension. Herein, our research goal was to decipher the association of healthy eating index-2015 (HEI-2015) with hypertension, and to explore potential gender differences.

METHODS

We collected the cross-sectional data of 42,391 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The association of HEI-2015 with hypertension was estimated using weighted multivariate logistic regression, with restricted cubic spline (RCS) regression being adopted to examine the nonlinearity of this association in both genders, and the stability of the results were examined by sensitivity analysis. We also performed subgroup analysis to detect potential difference in the link between HEI-2015 and hypertension stratified by several confounding factors.

RESULTS

After eliminating potential confounding bias, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for hypertension across higher HEI-2015 quartiles were 0.93 (0.85-1.03), 0.84 (0.77-0.93), and 0.78 (0.72-0.86) compared to the lowest quartile, respectively. HEI-2015 was nonlinearly and inversely associated with hypertension in all participants. The gender-specific RCS curves presented a U-shaped correlation in males, while showed a linear and inverse correlation in females. Besides, subgroup analyses showed a lower risk of hypertension in participants who were females, younger than 40 years, Whites, obese, and diabetic patients.

CONCLUSIONS

We determined a nonlinear and inverse association between HEI-2015 and hypertension in the US general population, and revealed a remarkable gender difference when adhering to a HEI-2015 diet for preventing hypertension.

Spectrum-effect relationship combined with bioactivity evaluation to discover the main anxiolytic active components of Baihe Dihuang decoction

ETHNOPHARMACOLOGICAL RELEVANCE

Anxiety disorders leads to a decline in quality of life and increased risk of morbidity and mortality. The Baihe Dihuang decoction (BDD) is a classic Chinese medical formula that has been widely used to treat anxiety disorders for thousands of years in China. However, the pharmacodynamic material that is responsible for the antianxiety of BDD remains unclear.

AIM OF THE STUDY

To screen the main ingredients of anti-anxiety in BDD based on the establishment of spectrum-effect relationship and verified experiment.

METHODS

The UPLC-Q-TOF/MS technique was utilized to establish fingerprints of various fractions of BDD and identify the main compounds. The anti-anxiety effects of BDD were comprehensively evaluated through multiple assessments, including the open field test, elevated plus maze test, and neurotransmitters tests. Then, the spectrum-effect relationship was established through Pearson correlation analysis, gray correlation analysis, orthogonal partial least squares regression analysis. The spectrum-effect relationship results were confirmed through various measures on an anxiety condition cell model, induced by a corticosterone and lipopolysaccharide intervention. These measures included assessing neuronal cell viability, morphology, apoptosis, synaptic damage, and the expression of neurotransmitters and inflammatory factors.

RESULTS

In the UPLC-Q-TOF-MS fingerprint, 46 common peaks were identified. The pharmacological results indicated that different fractions of BDD have strong effects on improving anxiety-like behavior and regulating neurotransmitters. Among them, butanol fraction has the highest comprehensive evaluation score of anti-anxiety efficacy, which is main active fraction of BDD for anti-anxiety. The analysis of the spectrum-effect relationship revealed that the 46 peaks exhibited varying degrees of correlation with the anti-anxiety efficacy indicators of BDD. Among them, 14 components have a high correlation with the anti-anxiety efficacy indicators, which may be the potential anti-anxiety efficacy components of BDD. The in vitro activity verification of active components verified our prediction, regaloside A, B, C, D, H, acteoside, and isoacteoside improved neuronal cell viability, cell morphology, apoptosis, and synaptic damage. Additionally, regaloside A, B, C, D, H and acteoside regulated the neurotransmitter levels, while regaloside A, B, C, D, acteoside and isoacteoside inhibited the levels of inflammatory cytokines.

CONCLUSION

The butanol fraction was found to be the main active fraction of BDD, and 14 compounds were the major anxiolytic active components. The results of verifying the major active components were consistent with the predicted results of the spectrum-effect analysis. The developed spectrum-effect analysis in this study demonstrates high accuracy and reliability for screening active components in TCMs.

Association between dietary inflammatory index and anemia in US adults

Background and aims

Anemia is a widespread global health concern, and recent research has unveiled a link between anemia and inflammation. The Dietary Inflammation Index (DII) is a novel tool used to assess the overall inflammatory potential of an individual's diet. However, until now, there have been no studies demonstrating a connection between DII and anemia. This study aimed to explore the relationship between DII and the risk of anemia among Americans, as well as to examine the influence of other risk factors on this association.

Methods

Data from 32,244 patients were collected from the National Health and Nutrition Examination Survey (NHANES) database spanning from 1999 to 2018. Using multivariable logistic regression, we examined the correlation between DII and anemia. Subgroup analyses and smoothed curve analyses were conducted to further investigate the association between DII and anemia.

Results

The analysis revealed a significant positive association between higher DII scores and increased anemia risk in the American population (Odds Ratio [OR] = 1.06, 95% Confidence Interval [CI] = 1.03 to 1.09, p < 0.0001). This association remained consistent in subgroup analyses, encompassing various age groups, distinct Body Mass Index (BMI) categories, varying diabetes mellitus statuses, histories of hypertension, females, individuals with a RIP <3.5, and Non-Hispanic Black individuals. Notably, the association was particularly significant among non-smokers. Smoothed curve fitting analysis demonstrated a linear relationship between DII and the prevalence of anemia.

Conclusion

Our findings underscore a positive correlation between the inflammatory potential of one's diet and the risk of anemia, especially when coupled with other risk factors. Consequently, reducing the consumption of pro-inflammatory foods may serve as one of the effective measures against the development of anemia. Given the variations in gender, age, BMI, and chronic diseases observed in our study, tailored policies could better cater to the specific needs of diverse populations.

Association between dietary inflammatory index and Stroke in the US population: evidence from NHANES 1999-2018

BACKGROUND

There is an increasing awareness that diet-related inflammation may have an impact on the stroke. Herein, our goal was to decipher the association of dietary inflammatory index (DII) with stroke in the US general population.

METHODS

We collected the cross-sectional data of 44,019 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The association of DII with stroke was estimated using weighted multivariate logistic regression, with its nonlinearity being examined by restricted cubic spline (RCS) regression. The least absolute shrinkage and selection operator (LASSO) regression was applied for identifying key stroke-related dietary factors, which was then included in the establishment of a risk prediction nomogram model, with the receiver operating characteristic (ROC) curve being built to evaluate its discriminatory power for stroke.

RESULTS

After confounder adjustment, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for stroke across higher DII quartiles were 1.19 (0.94-1.54), 1.46 (1.16-1.84), and 1.87 (1.53-2.29) compared to the lowest quartile, respectively. The RCS curve showed a nonlinear and positive association between DII and stroke. The nomogram model based on key dietary factors identified by LASSO regression displayed a considerable predicative value for stroke, with an area under the curve (AUC) of 79.8% (78.2-80.1%).

CONCLUSIONS

Our study determined a nonlinear and positive association between DII and stroke in the US general population. Given the intrinsic limitations of cross-sectional study design, it is necessary to conduct more research to ensure the causality of such association.

The association between dietary inflammation index and bone mineral density: results from the United States National Health and nutrition examination surveys

OBJECTIVE

To investigate the associations of dietary inflammation index (DII) with bone density and osteoporosis in different femoral areas.

METHODS

The study population was selected from the National Health and Nutrition Examination Survey (NHANES) with the exclusion criteria of age 18, pregnancy, or missing information on DII, femoral bone marrow density (BMD), estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (UACR), or had diseases which may influence systemic inflammation. DII was calculated based on the questionnaire interview of dietary recall within 24 h. Subjects' baseline characteristics were collected. The associations between DII and different femoral areas were analyzed.

RESULTS

After applying exclusion criteria, 10,312 participants were included in the study. Significant differences among DII tertiles were found in BMD or T scores (p < .001) of the femoral neck, the trochanter, the intertrochanter, and the total femur. High DII was associated with low BMDs and T scores in all the femoral areas (all p < .01). Compared to low DII (tertile1, DII < 0.380 as reference), in the femoral neck, the intertrochanter, and the total femur, increased DII is independently associated with increased the possibility of the presence of osteoporosis (OR, 95% CI: 1.88, 1.11-3.20; 2.10, 1.05-4.20; 1.94, 1.02-3.69, respectively). However, this positive association was only observed in the trochanteric area of the non-Hispanic White population after full adjustment (OR, 95% CI: 3.22 (1.18, 8.79)). No significant difference in the association of DII and the presence of osteoporosis were found in subjects with or without impaired kidney function (eGFR < 60 ml/min/1.73 m²).

CONCLUSION

High DII is independently related to declined femoral BMD of femoral areas.

Association between the dietary inflammatory index and gout in the National Health and Nutrition Examination Survey 2007-2018

Objective

The aim of our study was to investigate whether the Dietary Inflammatory Index (DII) correlated with gout in American adults.

Method

The study used data from the 2007-2018 National Health and Nutrition Examination Survey, with 27,710 adults participating. Initially, multivariable analysis was performed, with controls for covariates, to assess the link of DII and gout. Then, restricted cubic splines (RCS) were applied to model the nonlinear relationship of DII and gout. Furthermore, propensity score matching (PSM) as a further study of potential relationships was established. Eventually, subgroup analysis was performed.

Result

Participants within the highest DII quartile would be more susceptible to increased risk of gout in the univariate regression model (Q4 vs. Q1, OR = 1.31, CI: 1.05-1.63). Additionally, a positive correlation was detected between gout risk and DII after adjusting on drinking, smoking, gender, race, age, and BMI. Based on RCS analysis, we observed that the risk of gout raised sharply as DII values increased, then flattened, and increased sharply again when the DII was greater than approximately 2.5. After performing the PSM, it was observed that DII correlated in a positive way to the presence of gout on a fully adjusted multivariable model. Subgroup analysis revealed that the link of DII and gout showed no statistical significance in females, blacks, Mexicans, nor in the population that smoked.

Conclusion

Greater degrees of pro-inflammation correlate with a higher risk of gout and might be a predisposing factor for gout. Hence, tactics fostering an anti-inflammatory diet for preventing and improving gout in adults should be regarded.

Association of inflammatory indicators with intensive care unit mortality in critically ill patients with coronary heart disease

Objective

Coronary heart disease (CHD) is one of the major cardiovascular diseases, a common chronic disease in the elderly and a major cause of disability and death in the world. Currently, intensive care unit (ICU) patients have a high probability of concomitant coronary artery disease, and the mortality of this category of patients in the ICU is receiving increasing attention. Therefore, the aim of this study was to verify whether the composite inflammatory indicators are significantly associated with ICU mortality in ICU patients with CHD and to develop a simple personalized prediction model.

Method

7115 patients from the Multi-Parameter Intelligent Monitoring in Intensive Care Database IV were randomly assigned to the training cohort (n = 5692) and internal validation cohort (n = 1423), and 701 patients from the eICU Collaborative Research Database served as the external validation cohort. The association between various inflammatory indicators and ICU mortality was determined by multivariate Logistic regression analysis and Cox proportional hazards model. Subsequently, a novel predictive model for mortality in ICU patients with CHD was developed in the training cohort and performance was evaluated in the internal and external validation cohorts.

Results

Various inflammatory indicators were demonstrated to be significantly associated with ICU mortality, 30-day ICU mortality, and 90-day ICU mortality in ICU patients with CHD by Logistic regression analysis and Cox proportional hazards model. The area under the curve of the novel predictive model for ICU mortality in ICU patients with CHD was 0.885 for the internal validation cohort and 0.726 for the external validation cohort. The calibration curve showed that the predicted probabilities of the model matched the actual observed probabilities. Furthermore, the decision curve analysis showed that the novel prediction model had a high net clinical benefit.

Conclusion

In ICU patients with CHD, various inflammatory indicators were independent risk factors for ICU mortality. We constructed a novel predictive model of ICU mortality risk in ICU patients with CHD that had great potential to guide clinical decision-making.

Relationship between Dietary Decanoic Acid and Coronary Artery Disease: A Population-Based Cross-Sectional Study

BACKGROUND

Coronary artery disease (CAD) is a cardiovascular disease with significant personal health and socioeconomic consequences. The biological functions of decanoic acid and the pathogenesis of CAD overlap considerably; however, studies exploring their relationship are limited.

METHODS

Data from 34,186 Americans from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018 were analyzed. The relationship between dietary decanoic acid (DDA) and CAD prevalence was explored using weighted multivariate logistic regression models, generalized summation models, and fitted smoothing curves. Stratified analyses and interaction tests were conducted to explore the potential modifiers between them.

RESULTS

DDA was negatively associated with CAD prevalence, with each 1 g/d increase in the DDA being associated with a 21% reduction in CAD prevalence (odds ratio (OR) 0.79, 95% confidence interval (CI) 0.61-1.02). This relationship persisted after log10 and trinomial transformations, respectively. The OR after log10 transformation was 0.81 (95% CI 0.69-0.96), and the OR for tertile 3 compared with tertile 1 was 0.83 (95% CI 0.69-1.00). The subgroup analyses found this relationship to be significant among males and non-Hispanic white individuals, and there was a significant interaction (interaction p-values of 0.011 and 0.012, respectively).

CONCLUSIONS

DDA was negatively associated with the prevalence of CAD, and both sex and race may modify this relationship.

Association between dietary inflammatory index and Parkinson's disease from National Health and Nutrition Examination Survey (2003-2018): a cross-sectional study

Objected

To explore the association between Parkinson's disease (PD) and dietary inflammatory index (DII) scores in adults over 40 years old in the US.

Method

Data were collected from the National Health and Nutrition Examination Survey (NHANES) conducted from 2003 to 2018. A total of 21,994 participants were included in the study. A weighted univariate and multivariable logistic regression analysis was performed to investigate the association between the DII and PD, in which continuous variables or categorical variables grouped by tertiles was used. The relationship between DII and PD has been further investigated using propensity score matching (PSM) and a subgroup analysis stratified based on DII and PD characteristics. Moreover, restricted cubic spline (RCS) analysis was conducted to examine whether there was a nonlinear association between DII and PD.

Results

A total of 21,994 participants were obtained for statistical analysis, made up of 263 patients with PD and 21,731 participants without PD. Univariate and multivariable logistics regression analysis showed DII to be positively associated with PD before and after matching. Subgroup analysis revealed a statistical difference in non-Hispanic whites, but RCS analysis suggested that there was no nonlinear relationship between the DII and PD.

Conclusion

For participants over 40 years of age, higher DII scores were positively correlated with PD. In addition, these results support the ability of diet to be used as an intervention strategy for managing PD.

Effect of the Fermented Soy Q-CAN® Product on Biomarkers of Inflammation and Oxidation in Adults with Cardiovascular Risk, and Canonical Correlations between the Inflammation Biomarkers and Blood Lipids

Systemic low-grade inflammation plays a key role in the development of cardiovascular disease (CVD) but the process may be modulated by consuming fermented soy foods. Here, we aim to evaluate the effect of a fermented soy powder Q-CAN^® on inflammatory and oxidation biomarkers in subjects with cardiovascular risk. In a randomized crossover trial, 27 adults (mean age ± SD, 51.6 ± 13.5 y) with a mean BMI ± SD of 32.3 ± 7.3 kg/m² consumed 25 g daily of the fermented soy powder or an isoenergic control powder of sprouted brown rice for 12 weeks each. Between-treatment results showed a 12% increase in interleukin-1 receptor agonist (IL-1Ra) in the treatment group, whereas within-treatment results showed 23% and 7% increases in interleukin-6 (IL-6) and total antioxidant status (TAS), respectively. The first canonical correlation coefficient (r = 0.72) between inflammation markers and blood lipids indicated a positive association between high-sensitivity C-reactive protein (hsCRP) and IL-1Ra with LDL-C and a negative association with HDL-C that explained 62% of the variability in the biomarkers. These outcomes suggest that blood lipids and inflammatory markers are highly correlated and that ingestion of the fermented soy powder Q-CAN^® may increase IL-1Ra, IL-6, and TAS in individuals with CVD risk factors.

Systemic immune-inflammation index is associated with coronary heart disease: a cross-sectional study of NHANES 2009-2018

Background

Inflammation has been linked to the development of coronary heart disease (CHD). The systemic immune inflammation index (SII) is a useful biomarker of systemic inflammation. Our study aimed to explore the correlation between SII and CHD.

Methods

We conducted a multivariate logistic regression analysis, smoothing curve fitting, and segmented model comparison on 15,905 participants with a CHD prevalence of 3.31% and a mean age of 46.97 years.

Results

Adjusting for gender, age, and race, we found a negative association between SII and CHD [odds ratio (OR) 0.66; 95% confidence interval (CI) 0.48, 0.90]. There was an inverse trend where increasing SII was associated with decreasing odds of CHD (p for trend = 0.0017). After further adjustment, the association was strengthened, with a similar trend (p for trend = 0.0639). Smoothing curve fitting demonstrated a gender-specific association between SII and CHD.

Conclusions

Our findings suggest that higher SII values may be associated with a higher incidence of CHD, which varies by gender. SII may be a cost-effective and convenient method to detect CHD. Further studies are needed to confirm the causality of these findings in a larger prospective cohort.

The dietary inflammatory index and its association with the prevalence of hypertension: A cross-sectional study

Aims

We aim to investigate the association of the Dietary Inflammatory Index (DII) with the prevalence of hypertension in a large multiracial population in the United States.

Methods

Participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) were included in this cross-sectional study. Dietary information was obtained and used to calculate DII. Blood pressures of participants were measured by experienced examiners. The NHANES used the method of "stratified multistage probability sampling," and this study is a weight analysis following the NHANES analytic guidance. Weight logistic regression analysis was adopted to investigate the association of hypertension with DII. Least Absolute Shrinkage and Selection Operator (LASSO) regression was carried out to screen the most important dietary factors associated with the risk of hypertension. Moreover, a nomogram model based on key dietary factors was established; the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic power of the nomogram model for screening hypertension risk.

Results

A total of 45,023 participants were included in this study, representing 191 million residents in the United States. Participants with hypertension had an elevated DII compared with those without hypertension. Weight logistic regression showed that an increment of DII was strongly associated with hypertension after adjusting for confounding factors. The nomogram model, based on key dietary factors screened by LASSO regression, showed a favorable discriminatory power with an area under the curve (AUC) of 78.5% (95% CI: 78.5%-79.3%). Results of the sensitivity analysis excluding participants who received any drug treatment were consistent with those in the main analysis.

Conclusion

An increment of DII is associated with the risk of hypertension. For better prevention and treatment of hypertension, more attention should be paid to controlling dietary inflammation.