Association between dietary inflammatory index and low muscle mass in diabetes/prediabetes patients

Growing evidence has increasingly validated that individuals with diabetes/prediabetes have a higher prevalence of low skeletal muscle mass and function compared to healthy individuals. The anti-inflammatory diet is considered a promising and modifiable approach to optimize skeletal muscle quality. However, current evidence on the relation of dietary inflammatory potential with low muscle mass among diabetic/prediabetic patients is limited.

Dietary consumption was determined by trained staff using the 24-hour diet recall method, and the Dietary Inflammatory Index (DII) was scored based on a previously validated approach that included 26 food parameters. Dual-energy X-ray absorptiometry was used to assess the mass of skeletal muscle and low muscle mass was defined based on the sarcopenia index. Logistic regression was conducted to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). Restricted cubic spline (RCS) analysis was also performed to visually represent the relationship between DII and low muscle mass. Furthermore, sensitivity and subgroup analyses were conducted.

In this study, a total of 4269 eligible participants were registered, comprising 1975 (46.26 %) females and 2294 (53.74 %) males. The mean age was 49.98 ± 0.31 years old, and the mean DII score was 1.53 ± 0.04. Among them, 934 (21.88 %) patients were defined as having low muscle mass, while 3335 (78.12 %) were without low muscle mass. The highest tertile (T3) of DII had an 61 % increased risk of low muscle mass (OR = 1.61, 95%CI: 1.19-2.17, p for trend = 0.004) compared to the lowest tertile. The RCS curve displayed a linear dose-response relationship between DII score and low muscle mass risk in patients with diabetes/prediabetes. Subgroup and sensitivity analyses provided robustness to our results.

Our results indicated that a higher DII score was associated with an increased risk of low muscle mass among diabetes/prediabetes patients. These findings provided a nutritional strategy for diabetes/prediabetes patients to prevent skeletal muscle mass loss.