Association of the newly proposed dietary index for gut microbiota and all-cause and cardiovascular mortality among individuals with diabetes and prediabetes.

Background: The Gut Microbiota Dietary Index (DI-GM) is a newly developed assessment tool that quantitatively evaluates the nutritional modulation of intestinal microbial communities through systematic characterization of diet-microbiome interactions. The relationship between DI-GM and the risk of death has not been elucidated in patients with diabetes or prediabetes. The present cohort study examined the longitudinal relationship between DI-GM scores and both overall mortality and mortality from cardiovascular disease in this clinically vulnerable population. Method: The investigation used data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Analytical approaches, including multivariable-adjusted Cox proportional hazards regression, restricted cubic spline (RCS) modeling, stratified subgroup evaluations, and sensitivity assessments, were employed to examine the relationships linking DI-GM scores to mortality outcomes among individuals with diabetes or prediabetes. Result: During an average monitoring duration of 77.39 months within the cohort of 8,409 participants, 1,430 fatalities from all causes were documented, including 381 cases attributed to cardiovascular events. Multivariable-adjusted Cox regression analyses showed a negative correlation, with a 1-unit increase in DI-GM corresponding to an 8% lower all-cause mortality risk (HR = 0.92, 95% CI: 0.89-0.95; Conclusion: Among patients with diabetes or prediabetes, elevated DI-GM levels were negatively correlated with all-cause mortality and cardiovascular mortality risks.