AIMS/HYPOTHESIS Diet is one of the main lifestyle-related factors that can modulate the inflammatory process. Surprisingly the dietary inflammatory index (DII) has been little investigated in relation to type 2 diabetes, and the role of BMI in this relationship is not well established. We studied this association and the role of BMI in the inflammatory process in a large population-based observational study. METHODS A total of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort study were followed for 20 years. Incident type 2 diabetes cases were identified using diabetes-specific questionnaires and drug reimbursement insurance databases, and 3292 incident cases were validated. The DII was derived from a validated food frequency questionnaire. Multivariable Cox regression models estimated HRs and 95% CIs between DII and incident type 2 diabetes. Interactions were tested between DII and BMI on incident type 2 diabetes and a mediation analysis of BMI was performed. RESULTS Higher DII scores, corresponding to a higher anti-inflammatory potential of the diet, were associated with a lower risk of type 2 diabetes. Compared with the 1st quintile group, women from the 2nd quintile group (HR 0.85 [95% CI 0.77, 0.94]) up to the 5th quintile group (HR 0.77 [95% CI 0.69, 0.85]) had a lower risk of type 2 diabetes before adjustment for BMI. There was an interaction between DII and BMI on type 2 diabetes risk (pInteraction < 0.0001). The overall association was partly mediated by BMI (58%). CONCLUSIONS/INTERPRETATION Our findings suggest that a higher anti-inflammatory potential of the diet is associated with a lower risk of type 2 diabetes, and the association may be mediated by BMI. These results may improve our understanding of the mechanisms underlying the role of diet-related anti-inflammation in the pathogenesis of type 2 diabetes in women. Further studies are warranted to validate our results and evaluate whether the results are similar in men.

中文翻译：

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70,991名预期队列的人群中，饮食炎症指数和2型糖尿病风险持续了20年：BMI的中介作用。

目的/假设饮食是与生活方式相关的主要因素之一，可以调节炎症过程。令人惊讶的是，关于2型糖尿病的饮食炎症指数（DII）很少得到研究，而且BMI在这种关系中的作用还没有得到很好的确立。在一项基于人群的大型观察性研究中，我们研究了这种关联以及BMI在炎症过程中的作用。方法总共研究了70 991名来自E3N（全国教育妇女共同教育学院）队列研究的女性，为期20年。使用特定于糖尿病的调查表和药物报销保险数据库确定了2型糖尿病事件病例，并验证了3292例事件病例。DII来自经过验证的食物频率调查表。多变量Cox回归模型估计了DII与2型糖尿病事件之间的HR和95％CI。测试了DII和BMI在2型糖尿病事件中的相互作用，并对BMI进行了调解分析。结果较高的DII评分与饮食中较高的抗炎潜力相对应，与2型糖尿病的风险较低相关。与第一五分群相比，第二五分群（HR 0.85 [95％CI 0.77，0.94]）至第五五分群（HR 0.77 [95％CI 0.69，0.85]）的女性患第二型的风险较低调整BMI之前的糖尿病。DII和BMI在2型糖尿病风险中存在相互作用（pInteraction <0.0001）。整体关联部分由BMI介导（58％）。结论/解释我们的发现表明，饮食中较高的抗炎潜力与较低的2型糖尿病风险有关，并且该关联可能是由BMI介导的。这些结果可能会增进我们对饮食相关抗炎作用在女性2型糖尿病发病机理中的作用机理的理解。必须进行进一步的研究以验证我们的结果并评估结果是否与男性相似。