Dietary inflammatory potential and risk of advanced cardiovascular kidney metabolic syndrome analysis of national health and nutrition examination survey

Background Chronic inflammation plays a crucial role in the pathogenesis of cardiovascular, kidney, and metabolic diseases, which often coexist and significantly impact prognosis. The association between dietary inflammatory index (DII) and advanced cardiovascular-kidney-metabolic (CKM) syndrome remains unclear in the general population. Methods Data from 39,384 participants of National Health and Nutrition Examination Survey (NHANES) were analyzed. Participants were classified into 0–4 stages of CKM, with stages 3–4 defined as advanced CKM. DII was calculated based on 24-hour dietary recall data, and participants were stratified into quartiles of DII. The association between DII and advanced CKM was assessed using weighted multivariate logistic regression and restricted cubic spline (RCS) regression. Subgroup analyses were performed to identify potential effect modifiers. Results After adjusting for confounders, higher DII quartiles were associated with increased odds of advanced CKM compared to the lowest quartile, with adjusted odds ratios (95% confidence intervals) of 1.11 (0.98, 1.24) , 1.28 (1.12, 1.46) , and 1.63 (1.44, 1.84) , respectively (P for trend <0.001). The RCS analysis revealed a nonlinear positive association between DII and advanced CKM (P for overall <0.001, P for nonlinear =0.001). Significant interactions were observed in subgroups stratified by sex(P=0.004) and age (<60 vs. ≥60 years, P<0.001). Conclusions This study identified a significant association between DII and advanced CKM in the US general population. Further research is warranted to investigate the preventive effects of controlling dietary inflammation on CKM progression.