ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1595788
Association between Dietary Multi-Metal intake and the Risk of Diabetic Retinopathy: A Population-Based Study
Provisionally accepted
- 1Department of Urinary Nephropathy Center, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- 2Department of Hepatobiliary Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
- 3Department of Clinical Nutrition, Chongqing Red Cross Hospital, Jiangbei Qu, Chongqing, China
- 4Department of Plastic and Maxillofacial Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Objective: To investigate the association between dietary metals intake and the risk of diabetic retinopathy (DR) in adults with diabetes. Methods: Data from 2,822 U.S. adults with diabetes in National Health and Nutrition Examination Survey (NHANES) 2007–2016 were analyzed. Associations between the intake of six dietary metals and DR risk were assessed using multivariable logistic regression, Weighted Quantile Sum (WQS) regression, and Bayesian Kernel Machine Regression (BKMR). Restricted Cubic Spline (RCS) regression examined the dose-response relationship between intake of dietary metal and DR risk. Mediation analysis explored the underlying mechanisms. Results: Log10-transformed dietary Zinc (Zn) (OR = 0.53, 95% CI 0.35-0.80, p = 0.003) were negatively associated with the DR risk. WQS regression indicated that the combined effects of dietary metals intake were negatively associated with the risk of DR (OR = 0.79, 95 % CI 0.61-0.97, p = 0.024), with Zn contributing the most to the reduced risk (36.4%). BKMR model suggested the negative association between the combined intake of 6 metals and DR risk, with Zn receiving the highest posterior inclusion probability (PIP) (0.8574). Conclusion: In American adults with diabetes, elevated dietary metals intake, especially zinc, may be associated with a lower risk of DR.
Keywords: Diabetic Retinopathy, dietary metals intake, weighted quantile sum, Bayesian Kernel Machine Regression, NHANES
Received: 20 Mar 2025; Accepted: 30 May 2025.
Copyright: © 2025 Zhang, Peng, Lang, Fang, Zhang and Zhao. 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:
Haiyang Peng, Department of Hepatobiliary Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Keqin Zhang, Department of Urinary Nephropathy Center, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Andong Zhao, Department of Plastic and Maxillofacial Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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