eGFR partially mediates the association between Dietary Inflammatory Index and all-cause mortality in older adults
TL;DR
Pro-inflammatory diets independently increase all-cause mortality in older adults and are partially mediated through eGFR, partially mediated through eGFR using National Health and Nutrition Examination Survey data.
Abstract
This study examines the association between the Dietary Inflammatory Index (DII) and all-cause mortality in older adults and investigates the mediating role of estimated glomerular filtration rate (eGFR) using National Health and Nutrition Examination Survey data. We included 6300 participants aged ≥ 60 years from 9 National Health and Nutrition Examination Survey cycles (2001–2018). All-cause mortality (ascertained via linkage to the National Center for Health Statistics) was the primary endpoint. Cox proportional hazards models evaluated the association. Mediation analysis (mediation package, R 4.4.0) quantified eGFR’s contribution. The average DII of the enrolled subjects was 0.73 (0.04), and the average age was 68.84 (0.13) years. Over 116.4 months of follow-up, 1746 all-cause deaths occurred. Each 1-unit DII increase increased all-cause mortality risk by 5.6% (adjusted hazard ratio = 1.056, 95% confidence interval [CI]:1.020–1.094; P = .002). The highest DII tertile had 26% higher all-cause mortality vs the lowest (hazard ratio = 1.26, 95% CI:1.08–1.48). eGFR mediated 9.67% (95% CI:3.65–25.7%) of the DII-all-cause mortality association. Pro-inflammatory diets independently increase all-cause mortality in older adults, partially mediated through eGFR. Dietary interventions and renal monitoring may reduce this risk.