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The newly proposed dietary index for gut microbiota and its association with the risk of nonalcoholic fatty liver disease: the mediating role of body mass index

Diabetol Metab Syndr. 2025 Jun 21;17(1):237. doi: 10.1186/s13098-025-01801-w.

ABSTRACT

BACKGROUND AND AIMS: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with dietary habits and the gut microbiota. The dietary index for the gut microbiota (DI-GM) is a newly proposed index that reflects gut microbial diversity based on dietary intake. However, its relationship with NAFLD remains unclear. This study aimed to explore the association between DI-GM and the risk of NAFLD.

METHODS: In this cross-sectional study, we utilized data from the NHANES 2009-2018. Multivariable logistic regression, restricted cubic spline curves (RCS), subgroup analysis, and mediation analysis were used to evaluate the association between DI-GM and the risk of NAFLD.

RESULTS: A total of 4,923 participants were included in the study. According to the fully adjusted model, a significant inverse association was observed between DI-GM and NAFLD (OR = 0.883, 95% CI: 0.835-0.932, P < 0.001). After stratification by quartiles, compared with participants in the first quartile of DI-GM score, those in the fourth quartile had a 36.5% lower odds of developing NAFLD (OR = 0.635, 95% CI: 0.481-0.839, P = 0.002). Mediation analysis revealed that 72.69% of the association between DI-GM and NAFLD was mediated by BMI (P < 0.001). Subgroup analysis suggested that the association between DI-GM and NAFLD might be influenced by race (P for interaction < 0.05). RCS analysis revealed a linear correlation between DI-GM and NAFLD (P for nonlinear = 0.883).

CONCLUSIONS: DI-GM is negatively associated with NAFLD risk, with BMI mediating this relationship and race being a significant influencing factor.

PMID:40544245 | DOI:10.1186/s13098-025-01801-w

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