Abstract
OBJECTIVES: To examine the associations between the inflammatory potentials of diet and lifestyle, as measured by the Dietary Inflammation Score (DIS) and Lifestyle Inflammation Score (LIS), with the risk of type 2 diabetes mellitus (T2DM), hypertension and chronic kidney disease (CKD). DESIGN, SETTING: This retrospective cohort study used data collected between 2000 and 2012 from the Multi-Ethnic Study of Atherosclerosis cohort, which was conducted across six US communities. PARTICIPANTS: The study sample included 4736 participants for the analysis of T2DM, 2149 participants for hypertension and 4631 participants for CKD. OUTCOME MEASURES: The primary outcomes were the incidence of T2DM, hypertension and CKD during follow-up. RESULTS: During a median follow-up of 9.0 years, 537 participants developed T2DM, 1019 developed hypertension and 1067 developed CKD. DIS was not associated with T2DM in the overall population; however, women in the third quartile of DIS had a 52% higher risk of developing T2DM (HR 1.52; 95% CI 1.07 to 2.15). Also, individuals in the third quartile of DIS had a 22% higher risk of hypertension (1.22; 95% CI 1.02 to 1.47) in the overall population; however, no significant linear trend was observed across the quartiles (P-trend=0.397). Individuals in the fourth quartile of LIS had over twice the risk of developing T2DM (2.15; 95% CI 1.57 to 2.95), although no significant linear trend was observed across quartiles (P-trend <0.001). Additionally, the fourth quartile of LIS was associated with a 39% higher risk of hypertension (1.39; 95% CI 1.16 to 1.66) with a significant trend across quartiles (P-trend=0.001). The significant association between LIS and DIS and the risk of CKD was attenuated after adjusting for study confounders. CONCLUSION: This study highlights the role of diet and lifestyle-related inflammation in the development of hypertension and T2DM risk, providing novel evidence from a large, multiethnic US cohort. The findings underscore the potential of dietary and lifestyle strategies that target inflammation to reduce cardiometabolic disease risk.