{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:06:06Z","timestamp":1791943566665,"version":"4.3.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"38","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Tianjin Education Commission Research Project","award":["2022KJ240"],"award-info":[{"award-number":["2022KJ240"]}]},{"name":"Tianjin Key Medical Discipline (Specialty) Construction Project","award":["TJYXZDXK-037A"],"award-info":[{"award-number":["TJYXZDXK-037A"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,19]]},"abstract":"<jats:p>This study examined the association between the Dietary Inflammatory Index (DII) and depression in individuals with diabetes while investigating body mass index\u2019s (BMI) potential mediating role. DII quantifies diet-induced inflammation, which may worsen neuroinflammation and metabolic disturbances in diabetic patients, potentially elevating the risk of depression. We analyzed data from 4783 participants in the National Health and Nutrition Examination Survey (2009\u20132023) using generalized linear models to assess DII\u2019s effect of DII on depression in patients with diabetes. Mediation analysis was used to evaluate BMI\u2019s role of BMI in the DII\u2013Patient Health Questionnaire-9 relationship. The prevalence of depression among the diabetic participants was 32.41% (n\u2005=\u20051550). Higher DII scores significantly predicted an increased risk of moderate (odds ratio [OR]\u2005=\u20051.110, 95% confidence interval [CI]\u2005=\u20051.034\u20131.193, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.004), moderately severe (OR\u2005=\u20051.117, 95% CI\u2005=\u20051.036\u20131.247, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.010), and severe depression (OR\u2005=\u20051.178, 95% CI\u2005=\u20051.018\u20131.364, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.028), along with elevated Patient Health Questionnaire-9 scores (OR\u2005=\u20051.108, 95% CI\u2005=\u20051.020\u20131.204, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.016). BMI mediated 11.0% of this association (effect\u2005=\u20050.011; 95% CI\u2005=\u20050.001\u20130.022). Pro-inflammatory diets increased the risk of depression in adults with diabetes across moderate-to-severe categories, with BMI partially explaining this relationship. Clinical management should consider monitoring dietary inflammation and BMI reduction as potential depression prevention strategies in this population.<\/jats:p>","DOI":"10.1097\/md.0000000000044672","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T20:01:05Z","timestamp":1758571265000},"page":"e44672","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Body mass index as a mediator of the relationship between Dietary Inflammatory Index and depression in diabetes: Evidence from the National Health and Nutrition Examination Survey"],"prefix":"10.1097","volume":"104","author":[{"given":"Baoping","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixun","family":"Wang","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangru","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tianjin Dongli Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaofang","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3606-8739","authenticated-orcid":false,"given":"Yin","family":"Li","sequence":"additional","affiliation":[{"name":"Medical School of Tianjin University, Tianjin University, Tianjin, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenlin","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250928","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/XCE.0000000000000210","article-title":"Estimating life years lost to diabetes: Outcomes from analysis of national diabetes audit and office of national statistics data.","volume":"9","author":"Heald","year":"2020","journal-title":"Cardiovasc Endocrinol Metab"},{"key":"R2-20250928","doi-asserted-by":"crossref","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF diabetes atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045.","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"R3-20250928","doi-asserted-by":"crossref","first-page":"107843","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the international diabetes federation diabetes atlas, 9th edition.","volume":"157","author":"Saeedi","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"R4-20250928","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1016\/S0140-6736(20)32374-6","article-title":"The lancet commission on diabetes: Using data to transform diabetes care and patient lives.","volume":"396","author":"Chan","year":"2021","journal-title":"Lancet (London, England)"},{"key":"R5-20250928","doi-asserted-by":"crossref","first-page":"l5003","DOI":"10.1136\/bmj.l5003","article-title":"Trends in incidence of total or type 2 diabetes: systematic review.","volume":"366","author":"Magliano","year":"2019","journal-title":"BMJ"},{"key":"R6-20250928","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2337\/dci23-0085","article-title":"Economic costs of diabetes in the U.S. in 2022.","volume":"47","author":"Parker","year":"2024","journal-title":"Diabetes Care"},{"issue":"Suppl 1","key":"R7-20250928","first-page":"S20","article-title":"2. diagnosis and classification of diabetes: standards of care in diabetes-2024.","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"issue":"Suppl 1","key":"R9-20250928","first-page":"S52","article-title":"4. 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