摘要
Abstract
[Objective]To explore the association between dietary inflammatory Index(DII)and osteoporosis(OP)in elderly patients with type 2 diabetes mellitus(T2DM),and to clarify the dose-response relationship and potential threshold effect between DII and the risk of OP onset.[Method]A total of 167 elderly T2DM patients admitted to our hospital from January 2022 to December 2024 were enrolled in a cross-sectional study design,and DII was calculated using a semi-quantitative food frequency questionnaire(FFQ).They were divided into anti-inflammatory tendency group(DII<-5.10),intermediate group(-5.10≤DII≤-2.55)and pro-inflammatory tendency group(DII>-2.55)based on quintile.Bone mineral density(BMD),inflammatory factors CRP,IL-6,and bone metabolism indexes were detected.Inter-group differences and dose-response relationships between DII and OP were analyzed using restricted cubic spline(RCS)models.[Result]The age,BMI,duration of diabetes,saturated fat intake,total calorie intake and the level of inflammatory marker CRP in elderly patients with type 2 diabetes mellitus(T2DM)in the pro-inflammatory tendency group(DII>-2.55)were significantly higher than those in the middle group and the anti-inflammatory tendency group,while dietary fiber,25-OH-D level,MET-h/wk,and BMD of the femoral neck and lumbar vertebrae were significantly decreased.Moreover,the prevalence of osteoporosis(51.67%)was significantly higher than that in the middle group(30.56%)and the anti-inflammatory group(14.29%)(all P<0.001).In the pro-inflammatory group,the levels of pro-inflammatory factors IL-6,TNF-α,and IL-1β were significantly increased,the level of anti-inflammatory factor IL-10 was significantly decreased,the level of osteocalcin decreased,and the alkaline phosphatase,type I collagen C-terminal peptide,parathyroid hormone,and urinary calcium excretion increased in a gradient(all P<0.001).Multivariate Logistic regression analysis showed that after adjusting for confounding factors,DII had a significant dose-response relationship with the risk of osteoporosis(trend test P<0.001).The risk of onset in the intermediate group and the pro-inflammatory group was 2.589 times(95%CI:1.234～5.432)and 5.123 times(95%CI:2.345-11.187),respectively,that in the anti-inflammatory group.2.345-11.187).The restricted cubic spline model indicated that there was a nonlinear association between DII and the risk of osteoporosis(P nonlinearity=0.025).For every 1-unit increase in DII,the risk increased by 23.4%(OR=1.234,95%CI:1.156-1.318),and there was an inflection point at DII=-3.82,suggesting a threshold effect.[Conclu-sion]Pro-inflammatory diet pattern is significantly associated with OP risk in elderly T2DM patients,and there is a dose-response relation-ship and threshold effect,suggesting that dietary intervention to control inflammation may reduce the risk of OP.关键词
膳食炎症指数/2型糖尿病/骨质疏松症/炎症因子Key words
dietary inflammation index/type 2 diabetes/osteoporosis/inflammatory factor
