{"id":"0b18f02764cd","type":"article","url":"https://hartvaat.nl/2026/07/31/ontstekingsrijke-voeding-verhoogt-sterfterisico-bij-ckm-syndroom-nhanes-cohort/","title":"Ontstekingsrijke voeding verhoogt sterfterisico bij CKM-syndroom — NHANES-cohort","title_en":"Associations of dietary inflammatory and antioxidant indices with mortality in adults with cardiovascular-kidney-metabolic syndrome: A mediation analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Medicine","doi":"10.1097/MD.0000000000050040","source_url":"https://doi.org/10.1097/MD.0000000000050040","authors":["Yuefeng Li","Jing Kang"],"significance":5,"published":"2026-08-14","source_date":"2026-07-31","image":"https://hartvaat.nl/global/img/0155cc89a708.webp","kennis":["https://hartvaat.nl/kennis/farmacologie/glp1-agonisten-cardiologie/"],"congress":"","summary_en":"In a cohort of 21,420 NHANES participants with cardiovascular-kidney-metabolic (CKM) syndrome, higher dietary inflammatory index (DII) and lower composite dietary antioxidant index (CDAI) scores were independently associated with increased all-cause and cardiovascular mortality. The highest versus lowest DII tertile corresponded to a hazard ratio of 1.27, while a high CDAI reduced mortality risk to HRs of 0.84 and 0.78, respectively. Mediation analysis indicated that obesity and systemic inflammation indices accounted for only 4–9% of this association. These findings reinforce the potential role of anti-inflammatory, antioxidant-rich dietary patterns in reducing mortality risk among patients with CKM syndrome.","created":"2026-08-07T01:27:47Z","updated":"2026-08-10T10:35:41Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een analyse van 21.420 NHANES-deelnemers met het cardiovasculair-nier-metabool (CKM)-syndroom toont aan dat een hogere dietarische ontstekingsindex (DII) en een lagere composite dietarische antioxidantindex (CDAI) onafhankelijk samenhangen met een verhoogd risico op all-cause- en cardiovasculaire sterfte. De hoogste versus laagste tertiel van de DII werd geassocieerd met een hazard ratio van 1,27 voor beide uitkomsten, terwijl een hoge CDAI het risico verlaagde tot een HR van 0,84 en 0,78. Mediatieanalyse toonde aan dat indices voor obesitas en systemische ontsteking slechts een bescheiden deel (4–9%) van dit verband verklaren. Deze bevindingen ondersteunen het belang van ontstekingsremmende, antioxidantrijke voeding als preventieve strategie in de zorg voor patiënten met CKM-syndroom.","abstract_original":"Cardiovascular-kidney-metabolic (CKM) syndrome carries high mortality risk. Whether A Body Shape Index (ABSI), Weight-Adjusted Waist Index (WWI), Systemic Inflammation Response Index (SIRI), and Systemic Immune-Inflammation Index (SII) mediate the associations of Dietary Inflammatory Index (DII) and Composite Dietary Antioxidant Index (CDAI) with mortality in this population remains unknown. We included 21,420 adults with CKM from National Health and Nutrition Examination Survey 1999 to 2018 with mortality follow-up through December 31, 2019. DII and CDAI were calculated from 24-hour dietary recalls. Survey-weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cardiovascular mortality, modeling DII and CDAI as continuous variables and tertiles. Restricted cubic splines and 2-piecewise Cox models assessed nonlinearity. Mediation analyses evaluated indirect effects through ABSI, WWI, SIRI, and SII. During follow-up, 3532 all-cause and 1103 cardiovascular deaths occurred. In fully adjusted models, higher DII was associated with increased all-cause mortality (HR per 1-unit increase: 1.06, 95% CI: 1.04-1.09) and cardiovascular mortality (HR: 1.06, 95% CI: 1.02-1.10); the highest versus lowest tertile was associated with HRs of 1.27 (95% CI: 1.16-1.39) and 1.27 (95% CI: 1.08-1.49), respectively. Higher CDAI was associated with lower all-cause and cardiovascular mortality; the highest versus lowest tertile showed HRs of 0.84 (95% CI: 0.77-0.93) and 0.78 (95% CI: 0.65-0.93), respectively. Nonlinearity was observed between CDAI and all-cause mortality (P = .017). The percentage mediated by ABSI, WWI, SIRI, and SII ranged from approximately 4% to 9% for the association with all-cause mortality. In adults with CKM, DII and CDAI were independently associated with mortality outcomes, and ABSI, WWI, SIRI, and SII mediated a modest proportion of the association with all-cause mortality. Further studies are needed to confirm these findings."}