Higher dietary inflammatory index score tied to increased mortality in individuals with hyperuricemia: JAMA

The researchers suggest that controlling the intake of pro-inflammatory food might be a potential strategy to reduce all-cause and cardiovascular disease (CVD) mortality.

Hyperuricemia is a metabolic disorder resulting from prolonged dysfunction in purine metabolism, impaired elimination of uric acid, or excessive purine intake.

Dietary management is a crucial component of non-pharmacological treatment for hyperuricemia. Clinicians highly recommend a low-purine diet as it is suggested to improve hyperuricemia and prevent gout attacks. Furthermore, studies have found that probiotics, anthocyanins, and other bioactive compounds hold the potential to reduce hyperuricemia. Although these dietary components are believed to have anti-inflammatory effects, there is no knowledge of the overall inflammatory potential of the diet and its relationship with the physical health of hyperuricemia patients.

To fill this knowledge gap, Jiuliang Zhao, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China, and colleagues conducted the study to assess the association between Dietary Inflammatory Index score and mortality among adults with hyperuricemia.

For this purpose, the researchers collected data from the 2001-2018 NHANES cohorts. They obtained mortality information based on death certificate records from the National Death Index (NDI) through 31 December 2019. Cox proportional hazards regression models were used to investigate the associations between DII score and all-cause, CVD, and cancer mortality. 7786 participants with hyperuricemia were enrolled in the study.

Based on the findings, the researchers reported the following findings:

• The DII score ranged from −4.42 to 4.61. Higher DII score was significantly associated with higher levels of BMI, glycohemoglobin, glucose, LDL-cholesterol, and CRP.
• During 67851 person-years of follow-up, 1456 participants were identified with death including 532 CVD deaths and 246 cancer deaths.
• After adjusting for potential variables, a significantly higher risk of all-cause (HR:1.18) and CVD (HR:1.30) mortality was observed for individuals with higher DII scores.
• Considering the DII score as a continuous variable, the risk of all-cause and CVD mortality increases by 5% (HR:1.05) and 8% (HR:1.08) with each one-unit increment in DII, respectively.
• Subgroup analysis indicated that the association between DII and all-cause mortality among hyperuricemia participants was more significant in males.

In conclusion, the dietary inflammatory index score positively correlates with all-cause and CVD mortality in adults with hyperuricemia. Controlling the intake of pro-inflammatory food might be a potential strategy to reduce mortality.

Reference:

Zhou, M., Cai, B., Xiao, Q., Zou, H., Zeng, X., Zhao, J., & Zhu, X. Higher Dietary Inflammatory Index Increases Mortality Rate of Adults With Hyperuricemia: Findings From the National Health and Nutritional Examination Surveys (2001-2018). Arthritis Care & Research. https://doi.org/10.1002/acr.25336