Frontiers in public health · 2026
Association of energy-adjusted dietary inflammatory index with risk of cholelithiasis: a prospective cohort study.
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Zhu Jiayue, Zhai Yinghong, Yuan Lei, Dai Suming, Hu Fangyuan, Liu Xu
Аннотация
BACKGROUND: Cholelithiasis is a common, costly gastrointestinal disease with a rising global prevalence, and diet-related inflammation is closely associated with the onset of cholelithiasis. The energy-adjusted dietary inflammatory index (E-DII) provides a robust measure of dietary inflammatory potential by accounting for total energy intake, but prospective data on its link to cholelithiasis in general populations remain scarce.
METHODS: We explored this association in a large prospective cohort of 202,129 adults aged 40-69 from the UK Biobank. E-DII scores were derived from 24-h dietary recall data, and Cox regression models were used to examine associations between E-DII quartiles and cholelithiasis. Restricted cubic spline (RCS) regression characterized nonlinear relationships, with subgroup and sensitivity analyses (competing risk models, propensity score matching) validating findings.
RESULTS: In fully adjusted model, the hazard ratios (HRs) with 95% confidence intervals (CIs) for cholelithiasis across higher E-DII quartiles were 1.05(0.97, 1.12), 1.00 (0.93, 1.08) and 1.19 (1.11, 1.28) compared to the lowest quartile, respectively. The RCS analysis showed a nonlinear and positive association between E-DII and cholelithiasis. Risk increased when E-DII was below -1.891, decreased slightly from -1.891 to -0.507, and increased continuously after -0.507. Subgroup and sensitivity analyses largely corroborated the primary findings, indicating robustness of the observed associations. No association was observed between E-DII and cholelithiasis-related mortality.
CONCLUSION: In this large prospective cohort study, higher E-DII scores were associated with an increased risk of cholelithiasis, exhibiting a nonlinear pattern. These findings suggest that dietary adjustment may be beneficial for cholelithiasis prevention and warrant further targeted research.
METHODS: We explored this association in a large prospective cohort of 202,129 adults aged 40-69 from the UK Biobank. E-DII scores were derived from 24-h dietary recall data, and Cox regression models were used to examine associations between E-DII quartiles and cholelithiasis. Restricted cubic spline (RCS) regression characterized nonlinear relationships, with subgroup and sensitivity analyses (competing risk models, propensity score matching) validating findings.
RESULTS: In fully adjusted model, the hazard ratios (HRs) with 95% confidence intervals (CIs) for cholelithiasis across higher E-DII quartiles were 1.05(0.97, 1.12), 1.00 (0.93, 1.08) and 1.19 (1.11, 1.28) compared to the lowest quartile, respectively. The RCS analysis showed a nonlinear and positive association between E-DII and cholelithiasis. Risk increased when E-DII was below -1.891, decreased slightly from -1.891 to -0.507, and increased continuously after -0.507. Subgroup and sensitivity analyses largely corroborated the primary findings, indicating robustness of the observed associations. No association was observed between E-DII and cholelithiasis-related mortality.
CONCLUSION: In this large prospective cohort study, higher E-DII scores were associated with an increased risk of cholelithiasis, exhibiting a nonlinear pattern. These findings suggest that dietary adjustment may be beneficial for cholelithiasis prevention and warrant further targeted research.