Sköldstam Lars, Brudin Lars, Hagfors Linda, Johansson Gunnar
Department of Medicine, County Hospital, Visby, Sweden.
Nutr J. 2005 May 4;4:15. doi: 10.1186/1475-2891-4-15.
Several investigators have reported that clinical improvements of patients with rheumatoid arthritis (RA), from participating in therapeutic diet intervention studies, have been accompanied by loss of body weight. This has raised the question whether weight reduction per se can improve RA. In order to test this hypothesis, three previously conducted diet intervention studies, comprising 95 patients with RA, were pooled. Together with Age, Gender, and Disease Duration, change during the test period in body weight, characterised dichotomously as reduction or no reduction (dichoDeltaBody Weight), as well as Diet (dichotomously as ordinary diet or test diet), were the independent variables. Dependent variables were the difference (Delta) from baseline to conclusion of the study in five different disease outcome measures. DeltaESR and DeltaPain Score were both characterised numerically and dichotomously (improvement or no improvement). DeltaAcute Phase Response, DeltaPhysical Function, and DeltaTender Joint Count were characterised dichotomously only. Multiple logistic regression was used to analyse associations between the independent and the disease outcome variables.
Statistically significant correlations were found between Diet and three disease outcome variables i.e. DeltaAcute-Phase Response, DeltaPain Score, and DeltaPhysical Function. Delta Body Weight was univariately only correlated to DeltaAcute-Phase Response but not significant when diet was taken into account.
Body weight reduction did not significantly contribute to the improvement in rheumatoid arthritis when eating lacto-vegetarian, vegan or Mediterranean diets.
几位研究者报告称,类风湿性关节炎(RA)患者参与治疗性饮食干预研究后临床症状有所改善,同时体重减轻。这就引发了一个问题,即体重减轻本身是否能改善类风湿性关节炎。为了验证这一假设,我们汇总了三项之前进行的饮食干预研究,这些研究共有95名类风湿性关节炎患者。与年龄、性别和病程一起,测试期间体重的变化(分为减轻或未减轻,即二分法体重变化)以及饮食(分为普通饮食或试验饮食,即二分法)作为自变量。因变量是研究从基线到结束在五种不同疾病结局指标上的差异(Δ)。Δ血沉(ESR)和Δ疼痛评分均采用数值和二分法(改善或未改善)进行描述。Δ急性期反应、Δ身体功能和Δ压痛关节计数仅采用二分法进行描述。采用多元逻辑回归分析自变量与疾病结局变量之间的关联。
发现饮食与三个疾病结局变量之间存在统计学显著相关性,即Δ急性期反应、Δ疼痛评分和Δ身体功能。单因素分析时,Δ体重仅与Δ急性期反应相关,但在考虑饮食因素后无显著性。
食用乳素素食、纯素食或地中海饮食时,体重减轻对类风湿性关节炎的改善没有显著作用。