Shah Meena, Kavanaugh Arthur, Coyle Yvonne, Adams-Huet Beverley, Lipsky Peter E
Department of Internal Medicine, University of Texas at Southwestern Medical Center, Dallas, Texas, USA.
J Rheumatol. 2002 Oct;29(10):2122-8.
To evaluate the effect of a culturally sensitive cholesterol lowering diet program on lipid and lipoproteins, body weight, nutrient intakes, and quality of life (QOL) in patients with systemic lupus erythematosus (SLE).
Seventeen patients with SLE were randomized to a Step 2 diet intervention group or a control group for 12 weeks. The diet intervention was made up of weekly group sessions during the first 6 weeks followed by telephone counseling every 2 weeks for the last 6 weeks. Data on fasting lipid and lipoproteins, body weight, food intake (3 day food record), and QOL were collected at baseline, 6 weeks, and 12 weeks. Program acceptability was assessed in the diet group at 6 weeks.
The intervention was found to be highly acceptable and culturally sensitive. The changes in nutrient intakes at 6 and 12 weeks in the diet group were -49% and -33%, respectively, for cholesterol, -44% and -32%, respectively, for percentage calories from fat, and -46% and -32%, respectively, for percentage calories from saturated fat. The corresponding figures in the control group were +22% and -8% for cholesterol, +9% and +6% for percentage calories from fat, and +5% and +7% for percentage calories from saturated fat. The treatment by time interaction was significant for all the dietary variables (p = 0.0003 to 0.02). QOL was reported to improve by 15-17% in the diet group and decrease by 4-6% in the control group, and the treatment by time interaction was significant (p = 0.05). The changes in the physiological variables at 6 and 12 weeks in the diet group were -10% and -6%, respectively, for total cholesterol, -10% and -2%, respectively, for low density lipoprotein (LDL) cholesterol, -11% and -4%, respectively, for high density lipoprotein (HDL) cholesterol, -25% and -34%, respectively, for very low density lipoprotein (VLDL) cholesterol, -8% and -24%, respectively, for triglycerides, and -2% and -5%, respectively, for body weight. The corresponding figures in the control group were -5% and -3% for total cholesterol, -6% and -5% for LDL cholesterol, 0% and +12% for HDL cholesterol, +4% and -8% for VLDL cholesterol, -6% and -15% for triglycerides, and -5% and -6% for body weight. The treatment by time interaction was significant for HDL cholesterol (p = 0.04). A significant reduction was seen in the diet group for total cholesterol at 6 and 12 weeks, LDL and HDL cholesterol at 6 weeks, and body weight at 12 weeks (p = 0.0002 to 0.01).
This culturally sensitive cholesterol reducing diet program was highly accepted and effective in changing the diet and QOL of patients with SLE. The effect on serum lipids, lipoproteins, and body weight, however, was modest. A larger randomized study with a longer intervention period is necessary to test the effectiveness of a cholesterol-lowering diet on lipids and lipoproteins in patients with SLE.
评估一项具有文化敏感性的降胆固醇饮食计划对系统性红斑狼疮（SLE）患者的血脂、脂蛋白、体重、营养摄入及生活质量（QOL）的影响。
17例SLE患者被随机分为2步饮食干预组或对照组，为期12周。饮食干预在前6周由每周一次的小组会议组成，后6周每2周进行一次电话咨询。在基线、6周和12周时收集空腹血脂、脂蛋白、体重、食物摄入量（3天食物记录）及生活质量的数据。在6周时对饮食组的项目可接受性进行评估。
发现该干预具有高度可接受性且具有文化敏感性。饮食组在6周和12周时营养摄入的变化分别为：胆固醇 -49%和 -33%，来自脂肪的热量百分比 -44%和 -32%，来自饱和脂肪的热量百分比 -46%和 -32%。对照组相应的数据分别为：胆固醇 +22%和 -8%，来自脂肪的热量百分比 +9%和 +6%，来自饱和脂肪的热量百分比 +5%和 +7%。所有饮食变量的时间交互作用治疗效果显著（p = 0.0003至0.02）。据报告，饮食组的生活质量提高了15 - 17%，对照组下降了4 - 6%，时间交互作用治疗效果显著（p = 0.05）。饮食组在6周和12周时生理变量的变化分别为：总胆固醇 -10%和 -6%，低密度脂蛋白（LDL）胆固醇 -10%和 -2%，高密度脂蛋白（HDL）胆固醇 -11%和 -4%，极低密度脂蛋白（VLDL）胆固醇 -25%和 -34%，甘油三酯 -8%和 -24%，体重 -2%和 -5%。对照组相应的数据分别为：总胆固醇 -5%和 -3%，LDL胆固醇 -6%和 -5%，HDL胆固醇0%和 +12%，VLDL胆固醇 +4%和 -8%，甘油三酯 -6%和 -15%，体重 -5%和 -6%。HDL胆固醇的时间交互作用治疗效果显著（p = 0.04）。饮食组在6周和12周时总胆固醇、6周时的LDL和HDL胆固醇以及12周时的体重均显著降低（p = 0.0002至0.01）。
这项具有文化敏感性的降胆固醇饮食计划在SLE患者中具有高度可接受性，且在改变饮食和生活质量方面有效。然而，对血清脂质、脂蛋白和体重的影响较小。有必要进行一项干预期更长的大型随机研究，以测试降胆固醇饮食对SLE患者脂质和脂蛋白的有效性。
