ASSOCIATION OF DIETARY INFLAMMATORY INDEX WITH SYSTEMIC INFLAMMATION IN WELL-CONTROLLED TYPE 2 DIABETES MELLITUS

Abstract

bjective: Low-grade chronic inflammation contributes to residual cardiometabolic risk in type 2 diabetes (T2DM), even among patients who achieve glycemic targets. Dietary Inflammatory Index (DII) quantifies the inflammatory potential of habitual diet; however, its association with systemic inflammatory markers in well-controlled T2DM remains unclear. This study aimed to investigate the association between DII scores and circulating inflammatory markers in adults with well-controlled T2DM.Material and Methods: This cross-sectional study included 120 adults with T2DM and 30 healthy controls. Dietary intake was assessed using a validated 7-day food frequency questionnaire, and DII scores were calculated. Patients with T2DM were stratified into DII quartiles. Serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitive C-reactive protein (hs-CRP), along with metabolic parameters, were measured. Associations were evaluated using correlation and regression analyses, and effect sizes were estimated using Cohen’s d.Results: DII scores were positively correlated with IL-6 (r=0.421, p<0.001) and hs–CRP (r=0.312, p=0.002). IL 6 levels increased progressively across DII quartiles (p for trend <0.001), with a large effect size between the lowest and highest quartiles (Cohen’s d=0.84). Higher DII scores were associated with lower intakes of dietary fiber, polyunsaturated fatty acids, magnesium, and vitamin C (all p<0.05). Serum uric acid levels also increased across DII quartiles (p=0.044). No significant association was observed between DII and TNF-α.Conclusions: In adults with well-controlled T2DM, a more proinflammatory diet is associated with higher systemic inflammation, particularly elevated IL 6 levels. These findings suggest that dietary inflammatory potential may contribute to residual cardiometabolic risk beyond glycemic control.