The association between dietary inflammation index and bone mineral density: results from the United States National Health and nutrition examination surveys

Abstract

Objective

To investigate the associations of dietary inflammation index (DII) with bone density and osteoporosis in different femoral areas.

Methods

The study population was selected from the National Health and Nutrition Examination Survey (NHANES) with the exclusion criteria of age 18, pregnancy, or missing information on DII, femoral bone marrow density (BMD), estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (UACR), or had diseases which may influence systemic inflammation. DII was calculated based on the questionnaire interview of dietary recall within 24 h. Subjects’ baseline characteristics were collected. The associations between DII and different femoral areas were analyzed.

Results

After applying exclusion criteria, 10,312 participants were included in the study. Significant differences among DII tertiles were found in BMD or T scores (p < .001) of the femoral neck, the trochanter, the intertrochanter, and the total femur. High DII was associated with low BMDs and T scores in all the femoral areas (all p < .01). Compared to low DII (tertile1, DII < 0.380 as reference), in the femoral neck, the intertrochanter, and the total femur, increased DII is independently associated with increased the possibility of the presence of osteoporosis (OR, 95% CI: 1.88, 1.11–3.20; 2.10, 1.05–4.20; 1.94, 1.02–3.69, respectively). However, this positive association was only observed in the trochanteric area of the non-Hispanic White population after full adjustment (OR, 95% CI: 3.22 (1.18, 8.79)). No significant difference in the association of DII and the presence of osteoporosis were found in subjects with or without impaired kidney function (eGFR < 60 ml/min/1.73 m²).

Conclusion

High DII is independently related to declined femoral BMD of femoral areas.

Keywords:

• Dietary inflammatory index
• BMD
• osteoporosis
• femur bone

Acknowledgments

We thank the participants and staff of the NHANES.

Author contributions

SL and MZ designed the study. SL analyzed and interpreted the data. SL drafted the manuscript. SL and MZ revised the manuscript. All authors read and approved the final manuscript.

Ethical approval

The studies involving human participants were reviewed and approved by The National Center for Health Statistics Research Ethics Review Board. The patients/participants provided their written informed consent to participate in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data used in the study are publicly available online. (https://wwwn.cdc.gov/nchs/nhanes/Default.aspx and https://www.cdc.gov/nchs/data-linkage/mortality-public.htm).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (No. 82200813), and the Scientific Research Launch Project for new employees of the Second Xiangya Hospital of Central South University.