The dietary inflammatory index and its association with the prevalence of hypertension: A cross-sectional study

Nan Zhou; Zhi-Ping Xie; Qing Liu; Yun Xu; Si-Cheng Dai; Juan Lu; Jia-Yi Weng; Li-Da Wu

doi:10.3389/fimmu.2022.1097228

The dietary inflammatory index and its association with the prevalence of hypertension: A cross-sectional study

Front Immunol. 2023 Jan 18:13:1097228. doi: 10.3389/fimmu.2022.1097228. eCollection 2022.

Authors

Nan Zhou¹, Zhi-Ping Xie¹, Qing Liu¹, Yun Xu², Si-Cheng Dai¹, Juan Lu², Jia-Yi Weng³, Li-Da Wu⁴

Affiliations

¹ Health Examination Center, Huadong Sanatorium, Wuxi, China.
² Department of Anesthesiology, Huadong Sanatorium, Wuxi, China.
³ Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.
⁴ Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Abstract

Aims: We aim to investigate the association of the Dietary Inflammatory Index (DII) with the prevalence of hypertension in a large multiracial population in the United States.

Methods: Participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) were included in this cross-sectional study. Dietary information was obtained and used to calculate DII. Blood pressures of participants were measured by experienced examiners. The NHANES used the method of "stratified multistage probability sampling," and this study is a weight analysis following the NHANES analytic guidance. Weight logistic regression analysis was adopted to investigate the association of hypertension with DII. Least Absolute Shrinkage and Selection Operator (LASSO) regression was carried out to screen the most important dietary factors associated with the risk of hypertension. Moreover, a nomogram model based on key dietary factors was established; the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic power of the nomogram model for screening hypertension risk.

Results: A total of 45,023 participants were included in this study, representing 191 million residents in the United States. Participants with hypertension had an elevated DII compared with those without hypertension. Weight logistic regression showed that an increment of DII was strongly associated with hypertension after adjusting for confounding factors. The nomogram model, based on key dietary factors screened by LASSO regression, showed a favorable discriminatory power with an area under the curve (AUC) of 78.5% (95% CI: 78.5%-79.3%). Results of the sensitivity analysis excluding participants who received any drug treatment were consistent with those in the main analysis.

Conclusion: An increment of DII is associated with the risk of hypertension. For better prevention and treatment of hypertension, more attention should be paid to controlling dietary inflammation.

Keywords: LASSO; NHANES; dietary inflammatory index; hypertension; inflammation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Diet* / adverse effects
Humans
Hypertension* / epidemiology
Nutrition Surveys
Prevalence
United States / epidemiology

Grants and funding

This research was funded by the National Natural Science Foundation of China (Grant No. 82100360) and the tutorial system of Suzhou (Grant No. Qngg2022021).