Gan Ryan W, Bemis Elizabeth A, Demoruelle M Kristen, Striebich Christopher C, Brake Stacey, Feser Marie L, Moss LauraKay, Clare-Salzler Michael, Holers V Michael, Deane Kevin D, Norris Jill M
Department of Epidemiology, Colorado School of Public Health.
Division of Rheumatology, University of Colorado, Aurora.
Rheumatology (Oxford). 2017 Dec 1;56(12):2229-2236. doi: 10.1093/rheumatology/kex360.
Higher circulating omega-3 fatty acids (n-3 FAs) are associated with a lower prevalence of anti-CCP antibodies and RF in subjects without RA. We examined whether, in anti-CCP+ subjects, n-3 FAs also play a role in development of inflammatory arthritis (IA).
At Colorado-based health fairs from 2008 to 2014, participants without a previous diagnosis of RA who were anti-CCP3+ (n = 47) were recruited into a follow-up study; symptom assessments and joint examinations were conducted every 6 months for the determination of IA. We measured n-3 FAs as a percentage of total lipids in red blood cell membranes (n-3 FA%) at each visit.
We detected IA in 10 anti-CCP3+ subjects (21%) at the baseline visit. Increased total n-3 FA% in red blood cell membranes [odds ratio (OR) = 0.09, 95% CI: 0.01, 0.76], specifically docosapentaenoic acid (OR = 0.16, 95% CI: 0.03, 0.83) and docosahexaenoic acid (OR = 0.23, 95% CI: 0.06, 0.86), was associated with a lower odds of IA at the baseline visit, adjusting for n-3 FA supplement use, current smoking, RF+, elevated CRP+ and shared epitope. We followed 35 of the anti-CCP3+ subjects who were IA negative at baseline and detected 14 incident IA cases over an average of 2.56 years of follow-up. In a time-varying survival analysis, increasing docosapentaenoic acid significantly decreased risk of incident IA (hazard ratio = 0.52, 95% CI: 0.27, 0.98), adjusting for age at baseline, n-3 FA supplement use, RF+, CRP+ and shared epitope.
n-3 FAs may potentially lower the risk of transition from anti-CCP positivity to IA, an observation that warrants further investigation.
在无类风湿关节炎（RA）的受试者中，循环中较高水平的ω-3脂肪酸（n-3 FAs）与抗环瓜氨酸肽（CCP）抗体和类风湿因子（RF）的较低患病率相关。我们研究了在抗CCP阳性的受试者中，n-3 FAs是否也在炎性关节炎（IA）的发展中起作用。
在2008年至2014年于科罗拉多州举办的健康博览会上，招募了既往未诊断为RA且抗CCP3阳性（n = 47）的参与者进入一项随访研究；每6个月进行症状评估和关节检查以确定是否发生IA。每次就诊时，我们测量红细胞膜中n-3 FAs占总脂质的百分比（n-3 FA%）。
在基线就诊时，我们在10名抗CCP3阳性受试者（21%）中检测到IA。红细胞膜中总n-3 FA%增加[比值比（OR）= 0.09，95%置信区间（CI）：0.01，0.76]，特别是二十二碳五烯酸（OR = 0.16，95% CI：0.03，0.83）和二十二碳六烯酸（OR = 0.23，95% CI：0.06，0.86），在调整n-3 FA补充剂使用、当前吸烟情况、RF阳性、CRP升高和共同表位后，与基线就诊时IA的较低发病几率相关。我们对35名基线时IA阴性的抗CCP3阳性受试者进行了随访，在平均2.56年的随访期间检测到14例新发IA病例。在时变生存分析中，调整基线年龄、n-3 FA补充剂使用、RF阳性、CRP阳性和共同表位后，二十二碳五烯酸增加显著降低了新发IA的风险（风险比 = 0.52，95% CI：0.27，0.98）。
n-3 FAs可能会降低从抗CCP阳性转变为IA的风险，这一观察结果值得进一步研究。
