Wang Z, Shi FC, Hou SB, Sun QQ, Fang CY. Association of dietary index for gut microbiota and all-cause and cardiovascular mortality in patients with diabetes or prediabetes. World J Diabetes 2025; 16(7): 107111 [DOI: 10.4239/wjd.v16.i7.107111]
Corresponding Author of This Article
Zheng Wang, Associate Chief Physician, Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Intersection of Guangde Road and Leshui Road, Yaohai District, Hefei 230000, Anhui Province, China. wang20241007@163.com
Research Domain of This Article
Nutrition & Dietetics
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zheng Wang, Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei 230000, Anhui Province, China
Fa-Chao Shi, Department of Cardiology, Maanshan People's Hospital, Maanshan 243000, Anhui Province, China
Shan-Bing Hou, Quan-Quan Sun, Cao-Yang Fang, Department of Emergency, First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei 230000, Anhui Province, China
Co-corresponding authors: Zheng Wang and Cao-Yang Fang.
Author contributions: Fang CY made important contributions to study conception, method design, and writing and editing of the manuscript; Shi FC and Hou SB were primarily responsible for data analysis; Sun QQ was primarily responsible for data collection; Wang Z reviewed and edited the manuscript to ensure its scientific rigor and clarity, contributing critical input in refining the final draft.
Institutional review board statement: The study was exempt from ethical review and approval, as no additional institutional review board approval was necessary for the secondary analysis.
Informed consent statement: The National Health and Nutrition Examination Survey is a public database. All patients included in the database have received ethical approval. Users can download relevant data for free to conduct research and publish relevant articles.
Conflict-of-interest statement: The authors declared no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng Wang, Associate Chief Physician, Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Intersection of Guangde Road and Leshui Road, Yaohai District, Hefei 230000, Anhui Province, China. wang20241007@163.com
Received: March 17, 2025 Revised: April 7, 2025 Accepted: May 26, 2025 Published online: July 15, 2025 Processing time: 122 Days and 4 Hours
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.
Core Tip: There exists a clear relationship between dietary index for gut microbiota and the risk of all-cause mortality and cardiovascular mortality in patients with diabetes or prediabetes. Because of its high clinical significance, it is necessary to have a deep understanding of this relationship. In this study, we provide a new perspective for the management of diabetes and provide a new direction for future research and clinical practice. Through further studies, new biomarkers and interventions may be discovered, thereby improving the quality of life and survival of diabetic patients.
