Association of dietary index for gut microbiota and all-cause and cardiovascular mortality in patients with diabetes or prediabetes.

Abstract

Background: The dietary index for gut microbiota (DI-GM) demonstrates associations with diabetes prevalence and related mortality outcomes, serving as a nutritional assessment tool for microbial community evaluation.

Aim: To investigate connections between DI-GM values and survival endpoints in populations with impaired glucose metabolism, incorporating both total mortality and cardiovascular-related fatal events.

Methods: Cox proportional hazards modeling through survival analysis evaluated the relationship between DI-GM quartile classifications and fatal event probabilities. Restricted cubic spline modeling evaluated non-linear associations between continuous DI-GM values and mortality endpoints. Stratified analyses and robustness checks ensured the validity of the results.

Results: Higher DI-GM values showed a statistically significant negative correlation with total mortality risk [hazard ratio (HR) = 0.96, 95%CI: 0.93-1.00] and cardiovascular-related fatal outcomes (HR = 0.93, 95%CI: 0.87-0.99). When comparing quartiles, analysis indicated that participants in the upper quartile (Q4) had 17% decreased likelihood of all-cause death (HR = 0.83, 95%CI: 0.69-0.99) and 25% lower probability of cardiovascular mortality (HR = 0.75, 95%CI: 0.54-1.00) relative to those in the lowest quartile (Q1).

Conclusion: These findings position DI-GM as a protective determinant against mortality in glucose metabolism disorders. Dietary pattern optimization targeting DI-GM enhancement could constitute a strategic intervention in diabetes care protocols.