Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, SE-405 30, Gothenburg, Sweden.
Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Nutr J. 2021 Jan 23;20(1):9. doi: 10.1186/s12937-021-00663-y.
The chronic inflammation in patients with rheumatoid arthritis (RA) increases the risk for cardiovascular diseases (CVD). The contribution of diet as a risk factor for CVD among these patients is however not fully understood. The aim of this study is to investigate if a proposed anti-inflammatory diet improves cardiovascular profile in weight stable patients with RA.
Patients (n = 50) with RA were included in a cross-over trial. They were randomized to either a diet rich in whole grain, fatty fish, nuts, vegetables and fruit and supplemented with probiotics, or a control diet resembling average nutritional intake in Sweden, for ten weeks. After a 4-month washout they switched diet. Participants received food bags and dietary guidelines. Primary outcome was triglyceride (TG) concentration. Secondary outcomes were total-, high density lipoprotein- (HDL) and low density lipoprotein- (LDL) cholesterol, Apolipoprotein-B100 and -A1, lipoprotein composition, plasma phospholipid fatty acids and blood pressure.
Forty-seven patients completed at least one period and they remained weight stable. There was a significant between-dietary treatment effect in TG and HDL-cholesterol concentration in favor of intervention (p = 0.007 and p = 0.049, respectively). Likewise, Apolipoprotein-B100/A1 ratio shifted toward a less atherogenic profile in favor of the intervention (p = 0.007). Plasma fatty acids increased in polyunsaturated- and decreased in monounsaturated- and saturated fatty acids between diet periods in favor of the intervention period.
Blood lipid profile improved indicating cardioprotective effects from an anti-inflammatory dietary intervention in patients with RA.
This trial is registered at ClinicalTrials.gov as NCT02941055 .
类风湿关节炎（RA）患者的慢性炎症会增加心血管疾病（CVD）的风险。然而，饮食作为这些患者 CVD 风险因素的作用尚不完全清楚。本研究旨在探讨一种抗炎饮食是否能改善 RA 体重稳定患者的心血管状况。
本研究纳入了 50 例 RA 患者，进行交叉试验。他们被随机分配到富含全谷物、高脂肪鱼类、坚果、蔬菜和水果并补充益生菌的饮食组或类似于瑞典平均营养摄入的对照组，为期 10 周。经过 4 个月的洗脱期后，他们换用另一种饮食。参与者收到了食物袋和饮食指南。主要结局是甘油三酯（TG）浓度。次要结局包括总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、载脂蛋白 B100 和 A1、脂蛋白组成、血浆磷脂脂肪酸和血压。
47 例患者至少完成了一个周期，且体重稳定。干预组在 TG 和 HDL-胆固醇浓度上有显著的饮食治疗效果（p=0.007 和 p=0.049）。同样，载脂蛋白 B100/A1 比值向更不易患动脉粥样硬化的方向转变，有利于干预（p=0.007）。在两个饮食期之间，多不饱和脂肪酸的血浆脂肪酸增加，而单不饱和脂肪酸和饱和脂肪酸减少，有利于干预期。
血脂谱改善表明抗炎饮食干预对 RA 患者具有心脏保护作用。
本试验在 ClinicalTrials.gov 注册为 NCT02941055。
