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High Dietary Inflammatory Index Linked to Increased NAFLD Risk (OR 1.33, CI 1.23-1.44)

Key Takeaway
Consider dietary modifications to reduce NAFLD risk associated with high DII.

This meta-analysis systematically reviewed 18 studies involving 262,468 participants to evaluate the association between the Dietary Inflammatory Index (DII) and non-alcoholic fatty liver disease (NAFLD), as well as its progression to fibrosis. The primary endpoint was the association between DII and NAFLD incidence, which demonstrated a significant correlation with an odds ratio (OR) of 1.33 (95% CI: 1.23-1.44, P < 0.00001). Additionally, the analysis found a significant association between DII and the progression to fibrosis, with an OR of 1.36 (95% CI: 1.20-1.54, P < 0.00001). Subgroup analyses indicated that geographic region and diagnostic criteria contributed to heterogeneity among the studies. Egger's test suggested the presence of publication bias for NAFLD outcomes. No specific safety or adverse events were reported as the study focused on dietary indices rather than pharmacological interventions. Clinically, these findings suggest that a high DII, indicative of a pro-inflammatory diet, is associated with an increased risk of developing NAFLD and its progression to fibrosis. These results underscore the importance of dietary modifications in managing and potentially preventing NAFLD.

AI Accuracy Review: 9/10 · Auto-published
View Original Abstract ↓
BACKGROUND: The Dietary Inflammatory Index (DII) is a literature-based tool designed to predict inflammation. Previous studies suggest a potential association between the DII and non-alcoholic fatty liver disease (NAFLD). However, the relationship between the DII and both the incidence and progression of NAFLD remains unclear. METHODS: Systematic literature searches were conducted in PubMed, Web of Science, Embase, Scopus, and the Cochrane Library up to July 2025. A random-effects model was applied, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were performed to explore the sources of heterogeneity, while Egger's test was used to assess publication bias. Review Manager 5.4 and STATA 15.0 were employed for statistical analysis. RESULTS: Eighteen studies involving 262,468 participants were included. The data indicated a significant association between the DII and NAFLD (OR = 1.33, 95% CI: 1.23-1.44; P < 0.00001) and between the DII and fibrosis (OR = 1.36, 95% CI: 1.20-1.54; P < 0.00001). Subgroup analysis identified geographic region and diagnostic criteria as sources of heterogeneity. Egger's test revealed publication bias for NAFLD. CONCLUSION: A high DII was associated with an increased risk of NAFLD and an increased risk of progression to fibrosis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier CRD42025632168.
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