{
  "abstract": "Background: While the dietary inflammatory index (DII) is linked to cardiovascular disease (CVD) and mortality in the general population, its role in individuals with prediabetes and type 2 diabetes (T2D) remains understudied. Given the elevated inflammatory burden in this high-risk group, we aimed to examine the association between energy-adjusted DII (E-DII) and incident cardiovascular outcomes and all-cause mortality using a prospective cohort from the UK Biobank. Methods: We conducted a prospective cohort study using UK Biobank data, including 18,193 individuals with prediabetes and 6,469 with T2D, all free of cardiovascular disease and cancer at baseline. The E-DII was derived from 24-hour dietary recall data, incident CVD and all-cause mortality were ascertained through linked hospital and death records. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), with a median duration of 12.2 years (IQR: 11.5–13.0). Results: Among participants with T2D, an energy-adjusted DII > 1 (vs. ≥−1 to ≤1) was associated with a higher risk of cardiovascular events (HR 1.24, 95% CI 1.00–1.53) and all-cause mortality (HR 1.36, 95% CI 1.01–1.84). The association with cardiovascular mortality was not statistically significant (HR 1.50, 95% CI 0.76–2.94). No significant associations were observed among participants with prediabetes. Conclusions: A more pro-inflammatory dietary pattern, as measured by the E-DII, is independently associated with increased risks of incident cardiovascular events and all-cause mortality in individuals with T2D. These findings support the integration of DII into nutritional risk assessment for diabetic populations and highlight the potential of dietary modification to improve long-term outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Endocrinology, Xi’an Daxing Hospital Affiliated to Yan’an University, Xi’an, Shaanxi, China",
    "Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China",
    "Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China",
    "Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China",
    "Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ya Shi"
    },
    {
      "affs": [
        1
      ],
      "name": "Jingjing Zeng"
    },
    {
      "affs": [
        2
      ],
      "name": "Menglin Fan"
    },
    {
      "affs": [
        3
      ],
      "name": "Bo Chen"
    },
    {
      "affs": [
        4
      ],
      "name": "Zhaoxia Zhang"
    },
    {
      "name": "Bo Yang"
    },
    {
      "name": "Yang Tian"
    },
    {
      "name": "Guigao Guo"
    },
    {
      "name": "Nan Wang"
    },
    {
      "name": "Ying Xing"
    },
    {
      "name": "Shaoyong Xu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/frh8s8y8qzdsq.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0360954",
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  "id": "frh8s8y8qzdsq",
  "issns": [
    "1932-6203"
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  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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  "native_subjects": [
    [
      "plos",
      "/Biology and life sciences/Immunology/Immune response/Inflammation"
    ],
    [
      "plos",
      "/Biology and life sciences/Nutrition/Diet"
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    [
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      "/Medicine and health sciences/Cardiology/Cardiovascular medicine/Cardiovascular diseases"
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    [
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      "/Medicine and health sciences/Cardiology/Cardiovascular medicine/Cardiovascular diseases/Cardiovascular disease risk"
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    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Inflammation"
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    [
      "plos",
      "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus"
    ],
    [
      "plos",
      "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus/Type 2 diabetes"
    ],
    [
      "plos",
      "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus/Type 2 diabetes/Diet and type 2 diabetes"
    ],
    [
      "plos",
      "/Medicine and health sciences/Endocrinology/Endocrine disorders/Diabetes mellitus/Type 2 diabetes/Type 2 diabetes risk"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Immune response/Inflammation"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Cardiovascular diseases"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Cardiovascular diseases/Cardiovascular disease risk"
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    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus/Type 2 diabetes"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus/Type 2 diabetes/Diet and type 2 diabetes"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Metabolic disorders/Diabetes mellitus/Type 2 diabetes/Type 2 diabetes risk"
    ],
    [
      "plos",
      "/Medicine and health sciences/Nutrition/Diet"
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  "openalex": null,
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  "pmcid": null,
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  "published": "2026-11-11",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/frh8s8y8qzdsq.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T12:20:55Z",
      "native_id": "10.1371/journal.pone.0360954",
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      "url": "https://doi.org/10.1371/journal.pone.0360954"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:cardiovascular diseases",
      "subfield": "cardiovascular"
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    {
      "field": "medicine",
      "origin": "plos:endocrinology",
      "subfield": "endocrinology-metabolism"
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  "title": "Associations of dietary inflammatory index with incident cardiovascular outcomes and all-cause mortality in patients with prediabetes and type 2 diabetes mellitus: A prospective study of data from the UK Biobank",
  "title_text": "Associations of dietary inflammatory index with incident cardiovascular outcomes and all-cause mortality in patients with prediabetes and type 2 diabetes mellitus: A prospective study of data from the UK Biobank",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:20:02Z",
  "url": "https://research.draconitic.com/paper/frh8s8y8qzdsq",
  "venue": "PLOS One",
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}