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. 2024 May 3:11:1403438.
doi: 10.3389/fnut.2024.1403438. eCollection 2024.

Association between dietary inflammatory index and gallstones in US adults

Yanling Luo  1 , Xiaolian Gao  1   2 , Mingzhong Xiao  3   4   5 , Fen Yang  1 , Xinhong Zhu  1 , Guiyuan Qiao  1 , Cong Xiang  1 , Junxiu Tao  3   4   5
Affiliations

Association between dietary inflammatory index and gallstones in US adults

Yanling Luo et al. Front Nutr. .

Abstract

Introduction: Previous studies have found that diet's inflammatory potential is related to various diseases. However, little is known about its relationship with gallstones. The present study aims to investigate the relationship between dietary inflammatory index (DII) and gallstones.

Methods: Data were obtained from the 2003-2020 National Health and Nutrition Examination Survey (NHANES). We used the nearest neighbor propensity score matching (PSM) with a ratio of 1:1 to reduce selection bias. Logistic regression models estimated the association between DII and gallstones. The non-linear relationship was explored with restricted cubic splines (RCS). BMI subgroup stratification was performed to explore further the connection between DII and gallstones in different populations.

Results: 10,779 participants were included. Before and after PSM, gallstone group individuals had higher DII scores than non-gallstone group individuals (p < 0.05). Matched logistic regression analysis showed that DII scores were positively correlated with gallstone risk (adjusted OR = 1.14, 95% CI 1.01, 1.29). The stratified analysis showed that this association was stronger in overweight or obese people (adjusted OR = 1.18, 95% CI 1.03, 1.34). RCS analysis suggested that DII and gallstones showed a "J"-shaped non-linear dose-response relationship (p non-linear <0.001).

Conclusion: Higher DII score is positively associated with the risk of gallstones, particularly in overweight or obese population, and this relationship is a "J"-shaped non-linear relationship. These results further support that avoiding or reducing a pro-inflammatory diet can be an intervention strategy for gallstone management, particularly in the overweight or obese population.

Keywords: NHANES; dietary inflammatory index; gallstone; propensity score matching; restrictive cubic spline.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the sample selection from NHANES 2003–2020. NHANES, National Health and Nutrition Examination Survey.
Figure 2
Figure 2
Logistic regression analysis of DII and gallstones after PSM. BMI, Body Mass Index. Crude model: No covariates were adjusted. Model 1: Adjustments made for age, sex, race, education level, and PIR. Model 2: Adjustments same as that in model 1 plus BMI, physical activity, smoking status, alcohol, sleep and marital status. Model 3: Adjustments same as that in model 2 plus diabetes, hypertension and high cholesterol.
Figure 3
Figure 3
Restricted cubic spline models for the relationship between DII and the risk of gallstones in different populations after PSM. DII, Dietary Inflammatory Index. Adjusted OR and 95% CI are indicated by red lines and shades of blue. The model adjusted for age, sex, race, education level, PIR, BMI, physical activity, smoking status, alcohol, sleep, marital status, diabetes, hypertension and high cholesterol.
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