Association of Dietary and Lifestyle Inflammation Score with Type 2 Diabetes Mellitus and Cardiometabolic Risk Factors in Iranian Adults: Sabzevar Persian Cohort Study

Systemic inflammation may contribute to the initiation and progression of type 2 diabetes mellitus (T2DM) through diet and lifestyle. We examined the association of dietary inflammation score (DIS), lifestyle inflammation score (LIS) and dietary and lifestyle inflammation score (DLIS) with T2DM and cardiometabolic risk factors among Iranian adults. In this study, we identified and recruited 619 patients with T2DM and 2113 without T2DM from 35 to 75 years old men and women in the baseline phase of the Sabzevar Persian Cohort Study. Using a validated 115-item semi-quantitative FFQ, we calculated a 19-component DIS and a 3-component LIS weighted by circulating inflammation biomarkers. The DIS, LIS and DLIS associations with diabetes were assessed by multivariable logistic regression analysis. The average age of the participants was 48·29 (sd 8·53) (without T2DM: 47·66 (sd 8·42); with T2DM: 50·44 (sd 8·57)). Individuals in the highest compared with the lowest tertiles of DLIS (OR: 3·40; 95 % CI 2·65, 4·35; < 0·001), DIS (OR: 3·41; 95 % CI 2·66, 4·38; < 0·001) and LIS (OR: 1·15; 95 % CI 0·90, 1·46; = 0·521) had an increased risk of T2DM. For those in the highest relative to the lowest joint DIS and LIS tertiles, the results were OR: 3·37; 95 % CI 2·13, 5·32; < 0·001. No significant associations were found between DLIS and cardiometabolic risk factors, including blood pressure, liver enzymes and glycaemic and lipid profiles, except for waist circumference ( < 0·001) and waist-to-hip ratio ( = 0·010). A higher DIS and DLIS score was associated with a higher risk of T2DM, while the LIS score was not associated with T2DM risk.