The association between dietary inflammatory index with endometriosis: NHANES 2001–2006

Pan-Wei Hu, Bi-Rong Yang, Xiao-Le Zhang, Xiao-Tong Yan, Juan-Juan Ma, Cong Qi, Guo-Jing Jiang
2023 · W7074616351
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This study found a positive correlation between a higher dietary inflammatory index and the incidence of endometriosis in women aged 35 and older using NHANES 2001–2006 data.

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This study examined whether the dietary inflammatory index (DII) is associated with endometriosis using NHANES 2001–2006 data. DII was calculated from dietary information, and endometriosis status was classified from a gynecological history questionnaire (yes = cases, no = controls), with multivariate weighted logistic regression used to test the association. The paper found that endometriosis cases had higher DII than controls and that DII was positively correlated with endometriosis incidence after adjustment, with subgroup analyses showing no significant heterogeneity; in women aged 35+ the relationship appeared non-linear on smoothing curve fitting. The limitation explicitly noted is that endometriosis classification relied on questionnaire responses rather than clinical diagnosis. This paper is centrally about endometriosis — it analyzes the association between DII and endometriosis in NHANES participants.

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Abstract

Endometriosis is a common chronic inflammatory and estrogen-dependent disease that mostly affects people of childbearing age. The dietary inflammatory index (DII) is a novel instrument for assessing the overall inflammatory potential of diet. However, no studies have shown the relationship between DII and endometriosis to date. This study aimed to elucidate the relationship between DII and endometriosis. Data were acquired from the National Health and Nutrition Examination Survey (NHANES) 2001–2006. DII was calculated using an inbuilt function in the R package. Relevant patient information was obtained through a questionnaire containing their gynecological history. Based on an endometriosis questionnaire survey, those participants who answered yes were considered cases (with endometriosis), and participants who answered no were considered as controls (without endometriosis) group. Multivariate weighted logistic regression was applied to examine the correlation between DII and endometriosis. Subgroup analysis and smoothing curve between DII and endometriosis were conducted in a further investigation. Compared to the control group, patients were prone to having a higher DII (P = 0.014). Adjusted multivariate regression models showed that DII was positively correlated with the incidence of endometriosis (P < 0.05). Analysis of subgroups revealed no significant heterogeneity. In middle-aged and older women (age ≥ 35 years), the smoothing curve fitting analysis results demonstrated a non-linear relationship between DII and the prevalence of endometriosis. Therefore, using DII as an indicator of dietary-related inflammation may help to provide new insight into the role of diet in the prevention and management of endometriosis.
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PLoS ONE (Jan 2023) The association between dietary inflammatory index with endometriosis: NHANES 2001–2006 Abstract Endometriosis is a common chronic inflammatory and estrogen-dependent disease that mostly affects people of childbearing age. The dietary inflammatory index (DII) is a novel instrument for assessing the overall inflammatory potential of diet. However, no studies have shown the relationship between DII and endometriosis to date. This study aimed to elucidate the relationship between DII and endometriosis. Data were acquired from the National Health and Nutrition Examination Survey (NHANES) 2001–2006. DII was calculated using an inbuilt function in the R package. Relevant patient information was obtained through a questionnaire containing their gynecological history. Based on an endometriosis questionnaire survey, those participants who answered yes were considered cases (with endometriosis), and participants who answered no were considered as controls (without endometriosis) group. Multivariate weighted logistic regression was applied to examine the correlation between DII and endometriosis. Subgroup analysis and smoothing curve between DII and endometriosis were conducted in a further investigation. Compared to the control group, patients were prone to having a higher DII (P = 0.014). Adjusted multivariate regression models showed that DII was positively correlated with the incidence of endometriosis (P < 0.05). Analysis of subgroups revealed no significant heterogeneity. In middle-aged and older women (age ≥ 35 years), the smoothing curve fitting analysis results demonstrated a non-linear relationship between DII and the prevalence of endometriosis. Therefore, using DII as an indicator of dietary-related inflammation may help to provide new insight into the role of diet in the prevention and management of endometriosis.

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