A pro-inflammatory diet may contribute to increased parathyroid hormone (PTH) levels and hyperparathyroidism in individuals with and without chronic kidney disease (CKD), according to investigators.

The dietary inflammatory index (DII) is a scoring system designed to evaluate the inflammatory potential of diets. A positive score indicates a pro-inflammatory diet and a negative score indicates an anti-inflammatory diet. Pro-inflammatory diets include higher amounts of cholesterol, carbohydrates, calories, and saturated fats.

Investigators calculated DII scores for 7679 adults based on 24-hour dietary recall interviews from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) and grouped these individuals into DII tertiles.

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Mean PTH was significantly higher in the highest vs lowest DII tertile of inflammatory potential: 45.53 vs 41.42 pg/mL, Baihai Su, MD, and colleagues from Sichuan University in Chengdu, China, reported in Frontiers in Nutrition. The incidence of hyperparathyroidism (defined as intact PTH levels greater than 65 pg/mL) also was significantly higher in the highest vs lowest DII tertile: 13.28% vs 8.60%. Compared with the lowest DII tertile, the middle and high tertile had 1.6- and 2.7-fold increased odds of PTH elevation, respectively, and 1.3-fold increased odds of hyperparathyroidism.

In a fully adjusted model, each unit increase in DII score was associated with a PTH increase of 0.46 pg/mL.

As expected, mean PTH levels were significantly higher in individuals with than without CKD: 61.23 vs 41.80 pg/mL. Investigators observed an association between DII and PTH across the range of estimated glomerular filtration rate and among those with hypertension or diabetes. They also found consistent correlations across body mass index, sex, and age groups.

“Anti-inflammatory dietary management may be beneficial to reduce the risk of [hyperparathyroidism] both in the population with and without CKD,” according to Dr Su’s team.


Qin Z, Yang Q, Liao R, Su B. The association between dietary inflammatory index and parathyroid hormone in adults with/without chronic kidney disease. Front Nutr. Published online June 25, 2021. doi:10.3389/fnut.2021.688369