*Article* **Dietary Inflammation Index and Its Association with Long-Term All-Cause and Cardiovascular Mortality in the General US Population by Baseline Glycemic Status**

**Sheng Yuan 1,2,†, Chenxi Song 1,2,†, Rui Zhang 1,2,†, Jining He 1,2 and Kefei Dou 1,2,\***


**Abstract:** Dietary inflammatory potential has been proven to be correlated with the incidence of diabetes and cardiovascular diseases. However, the evidence regarding the impact of dietary inflammatory patterns on long-term mortality is scarce. This cohort study aims to investigate the dietary inflammatory pattern of the general US individuals by baseline glycemic status and to estimate its association with long-term mortality. A total of 20,762 general American adults with different glycemic statuses from the National Health and Nutrition Examination Survey were included. We extracted 24-h dietary information, and the dietary inflammatory index (DII) was calculated. The outcomes were defined as 5-year all-cause and cardiovascular mortality. Compared with the normoglycemia group, individuals with prediabetes and type 2 diabetes had higher DII scores (overall weighted *p* < 0.001). Compared with low DII scores, participants with high DII scores were at a higher risk of long-term all-cause mortality (HR: 1.597, 95% CI: 1.370, 1.861; *p* < 0.001) and cardiovascular mortality (HR: 2.036, 95% CI: 1.458, 2.844; *p* < 0.001). The results were stable after adjusting for potential confounders. Moreover, the prognostic value of DII for long-term all-cause mortality existed only in diabetic individuals but not in the normoglycemia or prediabetes group (*p* for interaction = 0.006). In conclusion, compared to the normoglycemia or prediabetes groups, participants with diabetes had a higher DII score, which indicates a greater pro-inflammatory potential. Diabetic individuals with higher DII scores were at a higher risk of long-term all-cause and cardiovascular mortality.

**Keywords:** diabetes mellitus; prediabetes; dietary inflammation index; nutrition; inflammatory diet; NHANES
