Sex Differences in the Association Between Dietary Inflammatory Index and Chronic Kidney Disease in U.S. Adults: Insights from NHANES 2011–2018”

Background studies on the association between dietary inflammatory index (DII) and chronic kidney disease (CKD) are limited. We aimed to examine the association between DII and CKD among U.S. adults with particular attention paid to sex differences. Methods A total of 19317participants were included in this study. The exposure variable was DII, which was calculated based on overall inflammatory effect scores. The outcome was CKD, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m ² or urinary albumin/creatinine (uACR) ≥ 30mg/g. Results The mean (SD) of age our study participants was 47.84 (18.35); and the mean (SD) of DII was 1.50 (1.91) (median 1.74). In multivariate logistic regression analysis, we observed that the OR value (95%CI) of CKD is 1.19 (1.14, 1.23), 1.12 (1.06, 1.19), and 1.16 (1.06, 1.27) in models 1, 2 and 3 for Per SD increment of DII. Compared with Participants with Q1(DII < 0.15), the adjusted ORs for participants in Q2 (0.15 ≤ DII < 1.74), Q3 (1.74 ≤ DII < 3.02) and Q4 (≥ 3.02)were 1.46 (95% CI: 1.14–1.88), 1.55 (95% CI: 1.20–1.99) and 1.52 (95% CI: 1.17, 1.98) ( p for trend < 0.05), respectively. However, this study observed that the independent positive correlation between DII and CKD appeared in women rather than men. Conclusions A higher level of DII is significantly associated with the increased prevalence of CKD, and sex can modify the relationship between them.