Sällström Torsten, Bärebring Linnea, Hulander Erik, Gjertsson Inger, Winkvist Anna, Lindqvist Helen M
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, Gothenburg, 405 30, Sweden.
Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
BMC Nutr. 2025 Apr 11;11(1):74. doi: 10.1186/s40795-025-01055-9.
The risk of atherosclerotic cardiovascular disease (ASCVD) is increased in Rheumatoid Arthritis (RA). Previous research has suggested that lipid metabolism is altered in RA, but research under postprandial conditions is scarce. The aim of this study was to investigate whether women with RA have a different lipemic and inflammatory response to a mixed meal containing red meat compared to women without RA.
Twenty-two women with RA, with modest disease activity, and 22 women without RA matched for age and body mass index (BMI) at the group level consumed a hamburger meal containing ca. 700 kcal (53 E% from fat, 27 E% from carbohydrate). Venous blood was sampled in the fasted state and after 30 min, 1, 2, 3 and 5 h and analysed for lipid species using nuclear magnetic resonance spectroscopy. Postprandial inflammation was measured by interleukin- 6 (IL- 6). The postprandial lipid response was calculated as the incremental area under the curve minimal value, and serial measurements were analysed by repeated measures analysis of variance. Lipid and inflammatory responses were compared by linear regression analysis, adjusted for age, BMI, physical activity, and baseline plasma concentration.
Plasma concentrations of IL- 6, triglycerides (TGs) and very low-density lipoprotein (VLDL) particles increased significantly after the meal compared to baseline within both groups, but no differences were observed between groups. However, the women with RA had a less pronounced response in cholesterol carried in VLDL particles (p = 0.03) and in TGs in the subfraction of VLDL particles with highest density (p = 0.03). No association was found between the response in TGs and IL- 6.
This study does not provide compelling evidence for any difference in the lipemic or inflammatory response in women with RA compared with age- and BMI-matched women without RA following ingestion of a mixed, high-fat meal containing red meat. The modest disease activity in women with RA should be considered when interpreting these findings. Subtle group differences found in the lipids carried by VLDL particles warrant further investigation.
The PIRA (Postprandial Inflammation in Rheumatoid Arthritis) trial was registered 2020-01 - 28 at Clinicaltrials.gov (NCT04247009).
类风湿关节炎（RA）患者发生动脉粥样硬化性心血管疾病（ASCVD）的风险增加。既往研究提示RA患者脂质代谢发生改变，但餐后状态下的相关研究较少。本研究旨在探讨与无RA的女性相比，患有RA的女性对含红肉的混合餐的血脂和炎症反应是否不同。
22名疾病活动度中等的RA女性和22名年龄及体重指数（BMI）在组间匹配的无RA女性食用了一顿约含700千卡（53%能量来自脂肪，27%能量来自碳水化合物）的汉堡餐。在空腹状态下以及餐后30分钟、1小时、2小时、3小时和5小时采集静脉血，使用核磁共振波谱法分析血脂成分。通过白细胞介素-6（IL-6）测定餐后炎症反应。餐后血脂反应计算为曲线下增量面积最小值，连续测量结果采用重复测量方差分析进行分析。通过线性回归分析比较血脂和炎症反应，并对年龄、BMI、体力活动和基线血浆浓度进行校正。
与基线相比两组餐后血浆IL-6、甘油三酯（TGs）和极低密度脂蛋白（VLDL）颗粒浓度均显著升高，但两组间未观察到差异。然而，RA女性在VLDL颗粒携带的胆固醇（p = 0.03）和密度最高亚组分的VLDL颗粒中的TGs（p = 0.03）方面反应较弱。未发现TGs反应与IL-6之间存在关联。
本研究未提供令人信服的证据表明，与年龄及BMI匹配的无RA女性相比，患有RA的女性在摄入含红肉的高脂肪混合餐后血脂或炎症反应存在差异。在解释这些结果时应考虑RA女性的疾病活动度中等这一情况。在VLDL颗粒携带的脂质中发现的细微组间差异值得进一步研究。
PIRA（类风湿关节炎餐后炎症）试验于2020年1月28日在Clinicaltrials.gov注册（NCT04247009）
