Relationship Between Dietary Inflammatory Index and Carotid Artery Calcification in Patients with Ischemic Stroke

Diet may influence systemic inflammatory status, vascular calcification, and, therefore, the development of atherosclerosis. The Dietary Inflammatory Index (DII) is a measure of the inflammatory potential of diet. Although previous studies have examined the relationship between DII and cardiovascular diseases, its specific association with carotid artery calcification in ischemic stroke patients remains insufficiently explored. This study aimed to evaluate the relationship between Dietary Inflammatory Index (DII) and carotid artery calcification in patients with ischemic stroke.

This is a retrospective cross-sectional analysis based on a prospective registry database. Patients with ischemic stroke were enrolled via Nanjing Stroke Registry Program. DII was calculated based on 39 food components with the help of a food frequency questionnaire. Carotid artery calcification was quantified as calcification score using the Agatston method based on computed tomography angiography. The data were compared among patients stratified by tertiles of DII. Multiple logistic regression models were used to evaluate the influence of DII on carotid artery calcification. Spearman analysis was used to evaluate the relationship between DII and ln-transformed carotid artery calcification score.

Of the 601 enrolled, carotid artery calcification was detected in 368 (61.23%) patients. Compared with patients with the lowest DII, those with higher DII had a higher ratio of stroke subtypes of large artery atherosclerosis (p =0.050), a higher calcification score (p <0.001), and a higher ratio of calcification (p <0.001). Other baseline characteristics, including sex and age, showed no significant differences across the DII tertiles. Patients with carotid artery calcification had significantly higher DII scores compared to those without calcification (p = 0.018). Logistic regression analysis showed that patients with the highest DII tertile had a higher risk of carotid artery calcification after adjusting for significant cofounders (OR =1.880, 95% CI, 1.205-2.932; p =0.005). Spearman correlation analysis indicated that DII was associated with ln-transformed carotid artery calcification score in patients with carotid artery calcification (R =0.110, p =0.035).

DII was associated with carotid artery calcification in patients with ischemic stroke. Considering a possible causal relationship, the mechanism of this relationship warrants further investigation.