Abstract

Background and Objectives: This study investigated associations of the Dietary Inflammatory Index (DII) and Chinese Healthy Diet Index (CHEI) with abdominal obesity in kidney transplant recipients (KTRs), with follow-up analyses further assessing the DII and mortality relationship. Methods and Study Design: We collected anthropometric and biochemical data; dietary consumption was evaluated using 3-day and 24-hour dietary records, with food quality assessed through energy-adjusted DII(E-DII) and CHEI. Binary logistic regression examined the association between E-DII, CHEI, and abdominal obesity in KTRs. The nonlinear connection between E-DII, CHEI, and abdominal obesity was studied using restricted cubic spline (RCS) analysis. The Kaplan-Meier survival curve was used to examine the survival rate of KTRs. Results: The study included 98 KTRs, 34 of whom had abdominal obesity. Logistic regression identified E-DII was a risk factor for abdominal obesity (OR: 5.52, 95%CI:1.19-10.4, p = 0.023), while the CHEI showed protective effects (OR: 0.939, 95%CI:0.893-0.987, p = 0.014). RCS demonstrated a positive linear association between E-DII and abdominal obesity in KTRs (p for overall = 0.042, p for nonlinear = 0.794). In contrast, CHEI exhibited a negative correlation (p for overall = 0.039, p for nonlinear = 0.082). Kaplan-Meier survival curve analysis revealed no statistically significant difference between groups, but the pro-inflammatory group exhibited a 3.8-fold higher mortality rate than the anti-inflammatory group. Conclusions: In KTRs, elevated E-DII and CHEI levels were associated with abdominal obesity, suggesting that reducing E-DII while increasing CHEI may contribute to its prevention and thus improve long-term survival outcomes.

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