Dietary index for gut microbiota and risk of hypertension: the mediating role of HOMA-IR in a five-year prospective cohort study in Iranian adults.

IF 4.1 2区医学 Q2 NUTRITION & DIETETICS

Nutrition & Metabolism Pub Date : 2026-05-03 DOI:10.1186/s12986-026-01121-4

Ali Nikparast, Mohsen Maleki, Nazanin Zamanian, Leila Sheikhi, Elahe Etesami, Gholamali Javdan, Reza Homayounfar, Jalaledin Mirzay Razaz

{"title":"Dietary index for gut microbiota and risk of hypertension: the mediating role of HOMA-IR in a five-year prospective cohort study in Iranian adults.","authors":"Ali Nikparast, Mohsen Maleki, Nazanin Zamanian, Leila Sheikhi, Elahe Etesami, Gholamali Javdan, Reza Homayounfar, Jalaledin Mirzay Razaz","doi":"10.1186/s12986-026-01121-4","DOIUrl":null,"url":null,"abstract":"Background: Diet-microbiota interactions may influence blood pressure via metabolic pathways, but prospective evidence on microbiota-supportive dietary patterns and incident hypertension, particularly in Middle Eastern populations, is limited. We examined the association between a Dietary Index for Gut Microbiota (DI-GM) and incident hypertension, and assessed whether insulin resistance, measured by homeostatic model assessment for insulin resistance (HOMA-IR), mediates this relationship.Methods: This prospective cohort included 5,185 Iranian adults free of hypertension at baseline. Usual dietary intake was assessed using a validated 125-item food-frequency questionnaire, and a 12-component DI-GM was computed. Incident hypertension over five years was defined according to JNC-7 criteria. Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension across DI-GM quartiles and per one-unit increment. Mediation by HOMA-IR was evaluated using bootstrapped mediation analysis with 10,000 resamples.Results: During follow-up, 2,150 participants experienced incident hypertension (41.5%). In fully adjusted models, participants in the highest DI-GM quartile had 21% lower odds of hypertension than those in the lowest quartile (OR 0.79, 95% CI 0.66-0.95), and each one-unit higher DI-GM was associated with 4% lower odds (OR 0.96, 95% CI 0.93-0.99). Results were robust in multiple sensitivity analyses. Approximately 34.5% of the association between DI-GM and hypertension was mediated by HOMA-IR.Conclusions: A microbiota-supportive dietary pattern is prospectively associated with a lower risk of incident hypertension, and about one-third of this relationship appears to operate through reduced insulin resistance. These findings support the promotion of gut-friendly dietary patterns in strategies for hypertension prevention.","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12986-026-01121-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Diet-microbiota interactions may influence blood pressure via metabolic pathways, but prospective evidence on microbiota-supportive dietary patterns and incident hypertension, particularly in Middle Eastern populations, is limited. We examined the association between a Dietary Index for Gut Microbiota (DI-GM) and incident hypertension, and assessed whether insulin resistance, measured by homeostatic model assessment for insulin resistance (HOMA-IR), mediates this relationship.

Methods: This prospective cohort included 5,185 Iranian adults free of hypertension at baseline. Usual dietary intake was assessed using a validated 125-item food-frequency questionnaire, and a 12-component DI-GM was computed. Incident hypertension over five years was defined according to JNC-7 criteria. Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension across DI-GM quartiles and per one-unit increment. Mediation by HOMA-IR was evaluated using bootstrapped mediation analysis with 10,000 resamples.

Results: During follow-up, 2,150 participants experienced incident hypertension (41.5%). In fully adjusted models, participants in the highest DI-GM quartile had 21% lower odds of hypertension than those in the lowest quartile (OR 0.79, 95% CI 0.66-0.95), and each one-unit higher DI-GM was associated with 4% lower odds (OR 0.96, 95% CI 0.93-0.99). Results were robust in multiple sensitivity analyses. Approximately 34.5% of the association between DI-GM and hypertension was mediated by HOMA-IR.

Conclusions: A microbiota-supportive dietary pattern is prospectively associated with a lower risk of incident hypertension, and about one-third of this relationship appears to operate through reduced insulin resistance. These findings support the promotion of gut-friendly dietary patterns in strategies for hypertension prevention.

查看原文本刊更多论文

膳食指数对肠道微生物群和高血压风险的影响：HOMA-IR在伊朗成人5年前瞻性队列研究中的介导作用

背景：饮食-微生物群的相互作用可能通过代谢途径影响血压，但关于微生物群支持的饮食模式和高血压事件的前瞻性证据，特别是在中东人群中，是有限的。我们研究了肠道微生物群膳食指数（DI-GM）与高血压发病率之间的关系，并评估了胰岛素抵抗是否介导了这种关系，胰岛素抵抗是通过胰岛素抵抗稳态模型评估（HOMA-IR）测量的。方法：该前瞻性队列包括5185名基线时无高血压的伊朗成年人。使用经过验证的125项食物频率问卷评估日常饮食摄入量，并计算12项DI-GM。根据JNC-7标准定义5年以上的高血压事件。多变量logistic回归估计了DI-GM四分位数和每单位增量的高血压的优势比（ORs）和95%置信区间（CIs）。通过10,000个样本的自举中介分析来评估HOMA-IR的中介作用。结果：在随访期间，2150名参与者经历了高血压事件（41.5%）。在完全调整的模型中，最高DI-GM四分位数的参与者患高血压的几率比最低四分位数的参与者低21% (OR 0.79, 95% CI 0.66-0.95)，并且每高一个单位的DI-GM与低4%的几率相关（OR 0.96, 95% CI 0.93-0.99）。结果在多重敏感性分析中是稳健的。大约34.5%的DI-GM和高血压之间的关联是由HOMA-IR介导的。结论：支持微生物群的饮食模式与较低的高血压发生风险相关，其中约三分之一的关系似乎是通过降低胰岛素抵抗来实现的。这些发现支持在高血压预防策略中促进肠道友好型饮食模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nutrition & Metabolism 医学-营养学

CiteScore

8.40

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition & Metabolism publishes studies with a clear focus on nutrition and metabolism with applications ranging from nutrition needs, exercise physiology, clinical and population studies, as well as the underlying mechanisms in these aspects. The areas of interest for Nutrition & Metabolism encompass studies in molecular nutrition in the context of obesity, diabetes, lipedemias, metabolic syndrome and exercise physiology. Manuscripts related to molecular, cellular and human metabolism, nutrient sensing and nutrient–gene interactions are also in interest, as are submissions that have employed new and innovative strategies like metabolomics/lipidomics or other omic-based biomarkers to predict nutritional status and metabolic diseases. Key areas we wish to encourage submissions from include: -how diet and specific nutrients interact with genes, proteins or metabolites to influence metabolic phenotypes and disease outcomes; -the role of epigenetic factors and the microbiome in the pathogenesis of metabolic diseases and their influence on metabolic responses to diet and food components; -how diet and other environmental factors affect epigenetics and microbiota; the extent to which genetic and nongenetic factors modify personal metabolic responses to diet and food compositions and the mechanisms involved; -how specific biologic networks and nutrient sensing mechanisms attribute to metabolic variability.