Dietary inflammatory index in progression and mortality risk of cardiovascular-kidney-metabolic syndrome: NHANES 1999-2018

Abstract Backgrounds Cardiovascular-kidney-metabolic syndrome (CKM) is a state-of-the-art definition associated with several diseases. Dietary inflammatory index (DII), is a tool quantify the inflammatory of one’s intake diet. Therefore, this study aims to detect DII in progression and mortality risk of CKM. Methods We enrolled participants from the nationally representative US cohort, the National Health and Nutrition Examination Survey, to evaluate the status of CKM stages from 1999 to 2018. The outcomes included all-cause mortality, cardiovascular mortality, and non-cardiovascular mortality. Results A total of 28,991 participants were enrolled in this study (mean ± SD age: 51 ± 16 years, 52.3% male). Increased DII was associated with CKM progression. Elevated DII was associated with increased risk of mortality compared to Q1 (all-cause mortality: Q2: HR: 1.17; 95%CI: 1.05-1.30; Q3:HR:1.30; 95%CI: 1.17-1.43; Q4: HR:1.28; 95%CI: 1.16-1.41; cardiovascular mortality: Q2: HR:1.12; 95%CI: 0.92-1.36; Q3: HR:1.19; 95%CI: 0.98-1.45; Q4: HR: 1.35, 95%CI: 1.10-1.66; non-cardiovascular mortality: Q2: HR: 1.19; 95%CI: 1.04-1.35; Q3: HR: 1.34; 95%CI:1.20-1.49; Q4: HR: 1.27; 95%CI: 1.12-1.43 )Restricted cubic splines (RCS) curves showed a linear relationship between DII and all-cause mortality (p for nonlinearity = 0.846), cardiovascular mortality (p for nonlinearity = 0.888), and non-cardiovascular mortality (p for nonlinearity = 0.927). Conclusions Elevated DII was associated with a higher risk of mortality outcomes and CKM progression, suggesting the potential benefit of an anti-inflammatory diet with a low DII in managing the CKM population.