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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1553467
This article is part of the Research Topic The Relationship between Nutrition and Frailty/Multimorbidity: Prevention and Clinical Nutritional Management View all 10 articles
Inflammatory Parameters Mediates the Relationship Between Dietary Index for Gut Microbiota and Frailty in Middle-aged and Older Adults in the United States: Findings from a Large-scale Population-based Study
Provisionally accepted- 1 Zhaoqing First People's Hospital, Zhaoqing, China
- 2 Department of Geriatrics, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
- 3 Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins Medicine, Maryland, Maryland, United States
Background Frailty is a prevalent geriatric syndrome marked by diminished physiological reserves and heightened vulnerability to stressors, leading to adverse health outcomes and imposing significant economic burdens on healthcare systems. Methods This study investigates the relationship between the Dietary Index for Gut Microbiota (DI-GM) and the risk of frailty in middle-aged and older adults, using data from the National Health and Nutrition Examination Survey (NHANES) collected from 2007 to 2018. Weighted logistic regression, subgroup analysis, and restricted cubic splines (RCS) were performed to evaluate the relationship between DI-GM and frailty risk. Additionally, a mediation analysis was conducted to investigate the influence of relevant inflammatory parameters from complete blood count, including leukocyte count, neutrophil count, the neutrophil to lymphocyte ratio (NLR), and the systemic inflammatory response index (SIRI), to elucidate how DI-GM may influence the onset and progression of frailty. Results In this cross-sectional analysis of 8,695 participants with a mean age of 65.56 years, 3,173 individuals were classified as frail. After adjusting for all covariates, a significant inverse relationship was observed between DI-GM and the risk of frailty. Quartile analysis revealed that participants in the highest quartile of DI-GM had significantly lower odds of frailty compared to those in the lowest quartile (OR: 0.80, 95% CI: 0.65-0.99, p = 0.04). Trend analyses across all models demonstrated a consistent inverse relationship between higher DI-GM quartiles and frailty odds (p < 0.0001 for the crude model; p = 0.001 for Model 1; p = 0.04 for Model 2). Subgroup analyses confirmed the stability of the impact of DI-GM on frailty risk across various subgroups. RCS showed that the risk of frailty decreased linearly with increasing DI-GM levels. Mediation analysis indicated significant effects for leukocyte count, neutrophil count, NLR, and SIRI, with mediation proportions of 5.7%, 7.9%, 4.4%, and 5.5%, respectively (all p < 0.001).The serum levels of DI-GM are inversely related to frailty, with part of this relationship
Keywords: Keyword Dietary Index for Gut Microbiota, DI-GM, Frailty, Inflammation, NHANES
Received: 30 Dec 2024; Accepted: 31 Mar 2025.
Copyright: © 2025 Yang, Wu, Duan, Chen and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tianrui Yang, Department of Geriatrics, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
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