Recent research has suggested that adherence to plant-based dietary index (PDI) may reduce the risk of type 2 diabetes and related complications like DN. Therefore, the aim of this study was to investigate the possible association of PDI with the odds of DN. We enrolled 105 eligible women with DN and 105 controls (30–65 years) who were referred to the Kowsar Diabetes Clinic in Semnan, Iran. A 147-iteme food frequency questionnaire (FFQ) was used to evaluate an overall PDI, healthy plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Biochemical variables and anthropometric measurements were assessed for all patients using the pre-defined protocols. According to our final analyze, after controlling for potential confounders, participants with greater adherence to overall PDI (OR: 0.29; 95% CI: 0.15–0.56; P < 0.001) and hPDI (OR: 0.30; 95% CI: 0.15–0.56; P < 0.001) had 71% and 70% lower odds of DN compared to those with a low adherence. Conversely, subjects with a higher adherence to the uPDI were positively associated with increased odds of DN (OR = 5.00; 95% CI = 2.78–8.98; P < 0.001) and (OR = 4.27; 95% CI = 2.24–8.14; P < 0.001) in the crude and adjusted models, respectively. The result of this study showed that greater adherence to overall PDI and hPDI was inversely associated with the odds of DN. However, further prospective studies are warranted to confirm these results. Plant-based diet; Diabetic nephropathy; Diabetes; case-control
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