Department of Medical Nutrition, Osaka City University Graduate School of Human Life Science, 3-3-138 Sugimoto-cho, Sumiyoshi-ku, Osaka 558-8585, Japan; Department of Nutrition Management, Osaka University Medical Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan.
Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
Clin Nutr. 2018 Apr;37(2):675-680. doi: 10.1016/j.clnu.2017.02.011. Epub 2017 Feb 21.
BACKGROUND & AIMS: The Mediterranean diet is reportedly effective in suppressing disease activity in rheumatoid arthritis (RA), but the key elements responsible for this effect remain unknown. The presented study therefore aimed to identify such elements.
This study included 208 consecutive patients with RA (RA group) and 205 age- and sex-matched healthy volunteers (controls) from the prospective "TOMORROW" cohort study that has been ongoing since 2010 were included in this study. Food and nutrient intake was assessed using the brief self-administered diet history questionnaire (BDHQ), Mediterranean diet scores were calculated based on intake by controls and disease activity was determined from disease activity scores in 28 joints and erythrocyte sedimentation rates (DAS28-ESR).
Intake of monounsaturated fatty acids (MUFA) was significantly lower in the RA, than in the control group (P = 0.003) and the ratio of consumed monounsaturated to saturated fatty acid (MUFA/SFA) significantly differed within the RA group after being sub-classified according to DAS28-ESR. Moreover, DAS28-ESR significantly correlated with MUFA/SFA intake after age adjustment (R = -0.228, P < 0.01). Logistic regression analysis selected high MUFA intake as an independent predictor of remission in the RA group with borderline boundary significance (odds ratio, 1.97; 95% CI, 0.98-3.98; P = 0.057). Changes in DAS28-ESR between 2010 and 2011 significantly correlated with MUFA/SFA intake after age adjustment (R = 0.180, P = 0.01).
Daily MUFA intake, a component of the Mediterranean diet score, might suppress disease activity in RA patients.
据报道，地中海饮食可有效抑制类风湿关节炎（RA）的疾病活动，但负责这种效果的关键因素仍不清楚。因此，本研究旨在确定这些因素。
本研究纳入了 208 例连续的 RA 患者（RA 组）和 205 例年龄和性别匹配的健康志愿者（对照组），这些患者来自自 2010 年开始的前瞻性“TOMORROW”队列研究。采用简短自我管理饮食史问卷（BDHQ）评估食物和营养素摄入情况，根据对照组的摄入量计算地中海饮食评分，并根据 28 个关节疾病活动评分和红细胞沉降率（DAS28-ESR）确定疾病活动度。
与对照组相比，RA 组的单不饱和脂肪酸（MUFA）摄入量明显较低（P=0.003），并且在根据 DAS28-ESR 进行亚组分类后，RA 组中消耗的 MUFA 与饱和脂肪酸（MUFA/SFA）的比例也有显著差异。此外，在年龄调整后，DAS28-ESR 与 MUFA/SFA 摄入量显著相关（R=-0.228，P<0.01）。逻辑回归分析选择高 MUFA 摄入量作为 RA 组缓解的独立预测因子，具有边界显著性（比值比，1.97；95%置信区间，0.98-3.98；P=0.057）。2010 年至 2011 年 DAS28-ESR 的变化与年龄调整后的 MUFA/SFA 摄入量显著相关（R=0.180，P=0.01）。
地中海饮食评分的组成部分——每日 MUFA 摄入量可能会抑制 RA 患者的疾病活动度。
