The Association of Dietary Inflammation Index with Incidence of Both All-cause and Cardiovascular Mortality among US Adults with Cardiovascular Diseases

Abstract Background: Dietary Inflammation Index (DII) increases the risk of cardiovascular disease (CVD). However, few studies have revealed an association between DII with Incidence of Both All-cause and CVD Mortality among CVD populations. Methods: The effect of DII on all-cause and CVD mortality was assessed using weighted multivariable Cox proportional hazards models. Weighted restricted cubic spline (RCS) and weighted Kaplan-Meier survival curves were used to determine the linearity between DII and mortality. Subgroup analysis was performed to explore whether the effect of DII on all-cause and CVD mortality was influenced by confounding factors. Results: The data in this study were obtained from The National Health and Nutrition Examination Survey (NHANES) 2003-2018. During the mean follow-up time of 7.13 years, all-cause mortality and cardiovascular mortality were 38.96% and 13.51%, respectively. Furthermore, we found a linear relationship between the DII and all-cause and CVD mortality. After full adjustment for potential confounders (Model 3), the presence of the DII increased the risk of all-cause mortality by 4.3% (HR, 1.043; 95% CI, 1.006-.082; P-value =0.023) and the risk of CVD mortality by 8.3% (HR, 1.083; 95% CI, 1.020-1.150; P-value =0.009). Weighted Kaplan-Meier survival curves and weighted RCS plots revealed that All-cause and CVD mortality increased as DII increased. Conclusion: Elevated DII levels were independently associated with an increased risk of all-cause and CVD mortality among CVD populations. However, the existence of a causal relationship between the two needs to be explored further.