Causal Inference Between Dietary Inflammatory Index And Mongolian Population With Impaired Fasting Glucose And Type 2 Diabetes Mellitus

Objective: This study carried out an epidemiological survey on Mongolian adults in Inner Mongolia Autonomous Region,to investigate the dietary intake of Mongolian population.The dietary inflammatory index(DII)was used to evaluate the relationship between the potential of dietary inflammation in Mongolian population,then we can explore the dietary inflammatory of Mongolian people potential for impaired fasting glucose(IFG)and type 2diabetes mellitus(T2DM),to clarify the causal relationship between pro-inflammatory dietary components and the diseases about T2 DM and IFG.Finally,we can provide scientific suggestions for the prevention and control of chronic diseases in Mongolian population.Methods: From 2018 to 2020,a multi-stage stratified cluster sampling method was used to conduct field epidemiological surveys in Tongliao,Xilin Gol League,and Hohhot of the Inner Mongolia Autonomous Region,and 2525 participant information collected.Data included general demographic information,personal medical history,life history and dietary intake.We conduct a physical examination for each participant to obtain body measurement information and blood biochemical indicators.According to the dietary intake of each participant,the dietary inflammatory index was used to evaluate the individual dietary inflammatory potential.Logistic regression analysis was used to explore the influence of dietary inflammatory index on IFG and T2 DM.Based on the results of logistic analysis,restricted cube bar plots were used to explore the dose-response relationship between DII and the risk of IFG and T2 DM.And then,mendelian randomization study was used to further clarify the causal associations between pro-inflammatory dietary components and the two diseases.Results:(1)After excluding participants with incomplete data,a total of 2143 participants were included.We found that the prevalence of the prevalence of IFG was 10.22%,and T2 DM in Mongolian adults was 11.15%.(2)The dietary inflammation index of the Mongolian population was 0.25(1.37),ranging from-3.30 to +2.06.(3)The intake of cereals and potatoes,soybeans and nuts,fresh vegetables,fresh fruits,dairy products,poultry and livestock meat,aquatic products,and milk and eggs in each group of DII was P<0.05,and the difference was statistically significant.Moisture,energy,protein,fat,carbohydrates,dietary fiber,cholesterol,saturated fatty acids,monounsaturated fatty acids,polyunsaturated fatty acids,ash,total vitamin A,beta-carotene,retinol,thiamine,riboflavin Nutrients such as vitamin C,vitamin E,calcium,phosphorus,potassium,sodium,magnesium,iron,zinc,selenium,copper,manganese,and alcohol were significantly different among the four groups(P<0.05).(4)Logistic regression analysis found that the OR and 95% CI were 1.065(0.914,1.241).DII score is positively associated with risk of IFG.For every one standard deviation increase in DII score,the risk of IFG increased by 23.2%,and the OR and 95% CI were 1.232(1.046,1.450).Compared with the group with the lowest DII score,the risk of IFG in the group with the highest DII score increased by 66.7%,and the OR and 95% CI were 1.667(1.052,2.641).However,the DII score was not associated with the risk of T2 DM.(5)Exploring the dose-response relationship between DII score and IFG using the restricted cubic spline,we was found that there was a nonlinear relationship between DII score and IFG(Non-linearity test,P = 0.040).If DII score is greater than 0.4,the risk of IFG is increased.(6)Mendelian randomization study found that the intake of saturated fatty acids and IFG,with an OR and 95% CI of 1.087(95% CI: 1.012,1.167).There was a positive causal associatio n between intake of carbohydrates and saturated fatty acids was positively correlated with the risk of T2 DM,and the O R and 95% CI were respectively 1.250(95%CI:1.027,1.521)and1.221(95%CI:1.003,1.487).After sensitivity analysis,the causal association results were still robust.Conclusion:(1)There is a slight inflammatory effect in the dietary intake of the Mongolian population,which is positively correlated with the risk of IFG,but is not associated with the risk of T2 DM.(2)There are differences between diet and dietary nutrient intake in different inflammatory effect groups.Moreover,when the DII score exceeds 0.4,the pro-inflammatory effect of the diet can lead to a prominent pathogenic effect of IFG in the Mongolian population.(3)There is a positive causal relationship between the intake of saturated fatty acids and IFG,and the intake of carbohydrates and saturated fatty acids and T2 DM.It is necessary to reduce the intake of carbohydrates and saturated fatty acids in the diet to regulate blood glucose levels and improve the health of the population.