间歇性禁食（斋月禁食）对银屑病关节炎疾病活动、肌腱端炎和指（趾）炎的影响：一项多中心研究。

The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study.

机构信息

Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, 5290002 Ramat Gan, Israel.

Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20161 Milan, Italy.

出版信息

Nutrients. 2019 Mar 12;11(3):601. doi: 10.3390/nu11030601.

Intermittent circadian fasting, namely Ramadan, is a common worldwide practice. Such fasting has a positive impact on psoriasis, but no data exist on its role in psoriatic arthritis (PsA)-a disease that is clearly linked to body mass index. We enrolled 37 patients (23 females and 14 males) with a mean age 43.32 ± 7.81 and they fasted for 17 h for one month in 2016. The baseline PsA characteristics were collected and 12 (32.4%) patients had peripheral arthritis, 13 (35.1%) had axial involvement, 24 (64.9%) had enthesitis, and 13 (35.1%) had dactylitis. Three patients (8.1%) were treated with methotrexate, 28 (75.7%) with TNF-α blockers, and 6 (16.2%) with IL-17 blockers. After a month of intermittent fasting, C-reactive protein (CRP) levels decreased from 14.08 ± 4.65 to 12.16 ± 4.46 ( < 0.0001), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) decreased from 2.83 ± 1.03 to 2.08 ± 0.67 ( = 0.0078), Psoriasis Area Severity Index (PASI) decreased from 7.46 ± 2.43 to 5.86 ± 2.37 ( < 0.0001), and Disease Activity index for PSoriatic Arthritis (DAPSA) decreased from 28.11 ± 4.51 to 25.76 ± 4.48 ( < 0.0001). Similarly, enthesitis improved after fasting, with Leeds Enthesitis Index (LEI) decreasing from 2.25 ± 1.11 to 1.71 ± 0.86 ( < 0.0001) and dactylitis severity score (DSS) decreasing from 9.92 ± 2.93 to 8.54 ± 2.79 ( = 0.0001). Fasting was found to be a predictor of a decrease in PsA disease activity scores (DAPSA, BASDAI, LEI, DSS) even after adjustment for weight loss. IL-17 therapy was found to be an independent predictor of decreases in LEI after fasting. These preliminary data may support the use of chronomedicine in the context of rheumatic diseases, namely PsA. Further studies are needed to support our findings.

间歇性禁食，即斋月，是一种常见的全球做法。这种禁食对银屑病有积极影响，但尚无关于其在银屑病关节炎（PsA）中的作用的数据——这种疾病显然与体重指数有关。我们招募了 37 名患者（23 名女性和 14 名男性），平均年龄为 43.32 ± 7.81 岁，他们在 2016 年禁食了一个月，每天禁食 17 小时。收集了基线 PsA 特征，12 名（32.4%）患者有外周关节炎，13 名（35.1%）有轴性受累，24 名（64.9%）有肌腱炎，13 名（35.1%）有指（趾）炎。3 名（8.1%）患者接受甲氨蝶呤治疗，28 名（75.7%）患者接受 TNF-α 阻滞剂治疗，6 名（16.2%）患者接受 IL-17 阻滞剂治疗。经过一个月的间歇性禁食，C 反应蛋白（CRP）水平从 14.08 ± 4.65 降至 12.16 ± 4.46（<0.0001），Bath 强直性脊柱炎疾病活动指数（BASDAI）从 2.83 ± 1.03 降至 2.08 ± 0.67（=0.0078），银屑病面积严重程度指数（PASI）从 7.46 ± 2.43 降至 5.86 ± 2.37（<0.0001），银屑病关节炎疾病活动指数（DAPSA）从 28.11 ± 4.51 降至 25.76 ± 4.48（<0.0001）。同样，肌腱炎在禁食后得到改善，利兹肌腱炎指数（LEI）从 2.25 ± 1.11 降至 1.71 ± 0.86（<0.0001），指（趾）炎严重程度评分（DSS）从 9.92 ± 2.93 降至 8.54 ± 2.79（=0.0001）。即使在考虑体重减轻的情况下，禁食也被发现是 PsA 疾病活动评分（DAPSA、BASDAI、LEI、DSS）降低的预测因素。禁食后 LEI 的降低被发现与 IL-17 治疗有关。这些初步数据可能支持在风湿性疾病（即银屑病关节炎）背景下使用时间生物学。需要进一步的研究来支持我们的发现。