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Peer-reviewedCC BYJournal of global health

Dietary patterns and odds of prevalent gout comorbidity in diabetes mellitus: a mediation analysis of glucose metabolism and renal function.

  • Xuelin He1,2
  • Jiayan Zheng3
  • Leyan Zheng3
  • Guanghui Ying2
  • Min Xia2
  • Zhaogui Chen2
  • Qiao Zhang4
  • Baode Chen5
  • Xia Liu6
  • Yongtao Li3
6 affiliations
  1. 1Kidney Disease Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  2. 2Department of Nephrology, Beilun People's Hospital, Ningbo, China
  3. 3State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  4. 4Phase I Clinical Research Center, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
  5. 5Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  6. 6Institute for Intelligent Bio/ChemManufacturing (iBCM), Zhejiang University (ZJU)-Hangzhou Global Scientific and Technological Innovation Center, Hangzhou, China
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Abstract

Background

While independent associations between dietary patterns and diabetes mellitus (DM) or gout have been established, their relationship in comorbid conditions remains unclear. We aimed to examine the associations between distinct dietary patterns and prevalent gout among individuals with DM.Methods

We retrieved data in this cross-sectional study from the National Health and Nutrition Examination Survey. We used logistic regression models and Restricted cubic splines to explore associations between five dietary patterns (healthy eating index 2020 (HEI-2020), dietary approaches to stop hypertension (DASH), alternate Mediterranean diet score (aMED), dietary inflammatory index, and alternative healthy diet index). We also conducted subgroup and mediation analyses.Results

In multivariable-adjusted models, HEI-2020 (odds ratio (OR) = 0.82; 95% confidence interval (CI) = 0.70-0.96, P = 0.015), DASH (OR = 0.83; 95% CI = 0.70-0.98, P = 0.031), and aMED (OR = 0.86; 95% CI = 0.74-0.99, P = 0.041) scores were significantly associated with lower odds of prevalent gout among individuals with DM, with no nonlinear trends observed. Subgroup analyses revealed no significant interactions. Mediation analyses suggested that the triglyceride-glucose index-ratio of waist circumference to height mediated 40.2% and 22.8% of the effects of the DASH and HEI-2020 patterns, respectively. Serum uric acid showed evidence of mediation for the aMED pattern accounting for 16.3% of the association.Conclusions

Among people with DM in the USA, adherence to HEI-2020, DASH, and aMED dietary patterns is associated with lower odds of prevalent gout comorbidity in people with DM. Dietary structure improvement may therefore be associated with a lower burden of gout comorbidity in this population.

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Cite

BibTeXRIS
BibTeX
@article{he2026dietary,
  title = {{Dietary patterns and odds of prevalent gout comorbidity in diabetes mellitus: a mediation analysis of glucose metabolism and renal function.}},
  author = {Xuelin He and Jiayan Zheng and Leyan Zheng and Guanghui Ying and Min Xia and Zhaogui Chen and Qiao Zhang and Baode Chen and Xia Liu and Yongtao Li},
  journal = {Journal of global health},
  year = {2026},
  month = oct,
  doi = {10.7189/jogh.16.04280},
  url = {https://europepmc.org/article/MED/42960890},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Dietary patterns and odds of prevalent gout comorbidity in diabetes mellitus: a mediation analysis of glucose metabolism and renal function.
AU  - Xuelin He
AU  - Jiayan Zheng
AU  - Leyan Zheng
AU  - Guanghui Ying
AU  - Min Xia
AU  - Zhaogui Chen
AU  - Qiao Zhang
AU  - Baode Chen
AU  - Xia Liu
AU  - Yongtao Li
PY  - 2026
DA  - 2026/10/30
JO  - Journal of global health
DO  - 10.7189/jogh.16.04280
UR  - https://europepmc.org/article/MED/42960890
AB  - Background  While independent associations between dietary patterns and diabetes mellitus (DM) or gout have been established, their relationship in comorbid conditions remains unclear. We aimed to examine the associations between distinct dietary patterns and prevalent gout among individuals with DM.Methods  We retrieved data in this cross-sectional study from the National Health and Nutrition Examination Survey. We used logistic regression models and Restricted cubic splines to explore associations between five dietary patterns (healthy eating index 2020 (HEI-2020), dietary approaches to stop hypertension (DASH), alternate Mediterranean diet score (aMED), dietary inflammatory index, and alternative healthy diet index). We also conducted subgroup and mediation analyses.Results  In multivariable-adjusted models, HEI-2020 (odds ratio (OR) = 0.82; 95% confidence interval (CI) = 0.70-0.96, P = 0.015), DASH (OR = 0.83; 95% CI = 0.70-0.98, P = 0.031), and aMED (OR = 0.86; 95% CI = 0.74-0.99, P = 0.041) scores were significantly associated with lower odds of prevalent gout among individuals with DM, with no nonlinear trends observed. Subgroup analyses revealed no significant interactions. Mediation analyses suggested that the triglyceride-glucose index-ratio of waist circumference to height mediated 40.2% and 22.8% of the effects of the DASH and HEI-2020 patterns, respectively. Serum uric acid showed evidence of mediation for the aMED pattern accounting for 16.3% of the association.Conclusions  Among people with DM in the USA, adherence to HEI-2020, DASH, and aMED dietary patterns is associated with lower odds of prevalent gout comorbidity in people with DM. Dietary structure improvement may therefore be associated with a lower burden of gout comorbidity in this population.
SN  - 2047-2978
SN  - 2047-2986
ER  -