Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of the Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
PLoS One. 2020 Feb 13;15(2):e0228852. doi: 10.1371/journal.pone.0228852. eCollection 2020.
To clarify the relationship between dietary habit and disease activity of rheumatoid arthritis (RA).
This study enrolled RA patients who met the ACR/EULAR 2010 classification criteria from Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort in 2015. 22-item food frequency questionnaire (FFQ) was taken for the measurement of dietary habit in a single-institution cohort of RA (Kyoto University Rheumatoid Arthritis Management Alliance: KURAMA) in 2015. The disease activities of RA using the Disease Activity Score calculated based on the erythrocyte sedimentation rate (DAS28-ESR), Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire (HAQ), and serum matrix metalloproteinase-3 (MMP-3) level, the use of disease-modifying anti-rheumatic drugs (DMARDs), disease duration, rheumatoid factor, anti-cyclic citrullinated antibody, and body mass index were also examined. All of them were combined and statistically analyzed.
441 RA patients (81% women; mean age 65 years; mean disease duration 15 years) were enrolled from the KURAMA cohort. Average Disease Activity Score-28 using the erythrocyte sedimentation rate (DAS28-ESR) was 2.7. Univariate analysis showed that intake frequency of vegetables had a statistically significant negative correlation with disease activity markers, such as DAS28-ESR (ρ = -0.11, p<0.01), Simplified Disease Activity Index (SDAI) (ρ = -0.16, p<0.001), matrix metalloproteinase-3 (MMP-3) (ρ = -0.21, p<0.0001), and Health Assessment Questionnaire (HAQ) (ρ = -0.13, p<0.01). Factor analysis with varimax rotation was done to simplify the relevance of disease activity to various food items. 22 foods were categorized into five dietary patterns: "seafoods", "vegetables/fruits", "meats/fried foods", "snacks", and "processed foods". The multivariate analysis adjusted for clinically significant confounders showed that "seafoods" had statistically significant negative correlations with DAS28-ESR (β = -0.15, p<0.01), SDAI (β = -0.18, p<0.001), MMP-3 (β = -0.15, p<0.01), and HAQ (β = -0.24, p<0.0001). "Vegetables/fruits" had statistically significant negative correlations with SDAI (β = -0.11 p<0.05), MMP-3 (β = -0.12, p<0.01), and HAQ (β = -0.11, p<0.05).
These results suggest that high intake frequency of vegetables/fruits and/or seafoods might correlate with low disease activity.
阐明饮食习惯与类风湿关节炎（RA）疾病活动之间的关系。
本研究纳入了 2015 年来自京都大学类风湿关节炎管理联盟（KURAMA）队列中符合 ACR/EULAR 2010 分类标准的 RA 患者。在 2015 年，对 RA 患者进行了单机构队列（京都大学类风湿关节炎管理联盟：KURAMA）的 22 项食物频率问卷（FFQ）测量饮食习惯。使用红细胞沉降率（DAS28-ESR）计算的疾病活动评分（DAS28-ESR）、简化疾病活动指数（SDAI）、健康评估问卷（HAQ）和血清基质金属蛋白酶-3（MMP-3）水平来评估 RA 的疾病活动，使用疾病修正抗风湿药物（DMARDs）、疾病持续时间、类风湿因子、抗环瓜氨酸抗体和体重指数也进行了检查。将所有这些因素结合起来进行了统计分析。
从 KURAMA 队列中纳入了 441 例 RA 患者（81%为女性；平均年龄 65 岁；平均病程 15 年）。平均红细胞沉降率 DAS28（DAS28-ESR）为 2.7。单因素分析显示，蔬菜的摄入频率与疾病活动标志物如 DAS28-ESR（ρ=-0.11，p<0.01）、简化疾病活动指数（SDAI）（ρ=-0.16，p<0.001）、基质金属蛋白酶-3（MMP-3）（ρ=-0.21，p<0.0001）和健康评估问卷（HAQ）（ρ=-0.13，p<0.01）呈统计学显著负相关。使用方差极大旋转进行因子分析，以简化疾病活动与各种食物之间的相关性。22 种食物被分为五种饮食模式：“海鲜”、“蔬菜/水果”、“肉类/油炸食品”、“零食”和“加工食品”。经过多变量分析调整了临床显著混杂因素后，结果表明“海鲜”与 DAS28-ESR（β=-0.15，p<0.01）、SDAI（β=-0.18，p<0.001）、MMP-3（β=-0.15，p<0.01）和 HAQ（β=-0.24，p<0.0001）呈统计学显著负相关。“蔬菜/水果”与 SDAI（β=-0.11，p<0.05）、MMP-3（β=-0.12，p<0.01）和 HAQ（β=-0.11，p<0.05）呈统计学显著负相关。
这些结果表明，蔬菜/水果和/或海鲜的高摄入频率可能与低疾病活动有关。
