Journal Article

Associations between the dietary inflammatory index, body mass index, and waist-to-height ratio and diagnosed and undiagnosed diabetes mellitus in adults in Guangxi, China

Zhou, Weiwen, Huang, Jiongli, Li, Zhongyou, Chen, Yuzhu, Fang, Zhifeng, Li, Yan, Li, Xiaopeng, Li, Hai, Qing, Qiulan

2025

Overview

Background The relationships between the dietary inflammatory index (DII), body mass index (BMI), and waist‒to-hip ratio (WtHR) and both diagnosed diabetes mellitus (DDM) and undiagnosed diabetes mellitus (UDDM), as well as the contributions of these factors, have not yet been comprehensively evaluated. This study aimed to investigate this association and elucidate the roles of DII, BMI, and the WtHR in the development of diabetes. Methods This was a cross-sectional study involving 3687 participants aged 18 to 69 years were selected from the China National Nutrition and Health Survey (CNNHS 2010 to 2013) and the China Adult Chronic Disease and Nutrition Surveillance (CACDNS 2015) in Guangxi. DII scores were calculated from a 3-day, 24-hour (3d 24 h) dietary survey combined with the weighing method. Unconditional logistic regression, restricted cubic spline (RCS), and weighted quantile sum (WQS) models were utilized to assess the associations between DII, BMI, WtHR, and both DDM and UDDM. Results The overall prevalence of TDM was 6.6%, comprising 40.6% DDM and 59.4% UDDM cases. Compared with Q1 (the lowest proinflammatory group), subjects in Q4 and Q5 exhibited significantly higher TDM risk, with ORs (95% CI) of 1.65 (1.06, 2.56) and 1.88 (1.21, 2.92), respectively. This association was particularly pronounced in UDDM, where a significant dose-response relationship emerged (P-trend = 0.006), with Q5 demonstrating the highest diabetes risk which OR (95% CI) was 1.98 (1.16, 3.40). DII scores and the risks of TDM and UDDM were linear (all P values < 0.05) but no association between the DII and DDM risk. There is a nonlinear relationship between BMI and DDM risk, a linear relationship with UDDM risk, and significant positive correlations between the WtHR and both DDM and UDDM risk. WtHR emerged as the primary contributor (weight = 0.69) in participants with DDM. For participants with UDDM, DII emerged as the primary determinant, outweighing BMI (weight = 0.37 vs. 0.35) and the WtHR (weight = 0.28). Conclusions A high-proinflammatory diet is significantly linked to increased risks of both DDM and UDDM. BMI and the WtHR also exert substantial yet differential influences.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Adults / Aged / Analysis / Biostatistics / Body height / Body Mass Index / Body size / Body weight / Care and treatment / China - epidemiology / Chronic diseases / Chronic illnesses / Complications and side effects / Cross-Sectional Studies / Development and progression / Diabetes / Diabetes mellitus / Diabetes Mellitus - diagnosis / Diabetes Mellitus - epidemiology / Diagnosed diabetes mellitus / Diet - statistics & numerical data / Diet therapy / Dietary inflammation index / Disease control / Disease prevention / Dose-response relationship / Energy intake / Environmental Health / Epidemiology / Female / Health aspects / Health risks / Health surveys / Humans / Inflammation / Inflammation - epidemiology / Insulin / Laboratories / Male / Medical diagnosis / Medicine / Medicine & Public Health / Mental disorders / Middle Aged / Nutrition monitoring / Nutrition research / Nutrition Surveys / Obesity / Prevalence studies (Epidemiology) / Public Health / Quality control / Questionnaires / Risk / Risk Factors / Signal transduction / Surveys / Tumor necrosis factor-TNF / Type 2 diabetes / Undiagnosed diabetes mellitus / Vaccine / Waist-Height Ratio / Waist-to-height ratio / Weight / Young Adult