Dietary Omega Polyunsaturated Fatty Acid Intake and Patient-Reported Outcomes in Systemic Lupus Erythematosus: The Michigan Lupus Epidemiology and Surveillance Program
Dietary Omega Polyunsaturated Fatty Acid Intake and Patient-Reported Outcomes in Systemic Lupus Erythematosus: The Michigan Lupus Epidemiology and Surveillance Program
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DOI：
10.1002/acr.23925
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发表时间：
2020-07-01
影响因子：
4.7
通讯作者：
Zick, Suzanna M.
中科院分区：
文献类型：
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作者：
Charoenwoodhipong, Prae;Harlow, Sioban D.;Zick, Suzanna M.
目的研究膳食中omega-3(n-3；一般抗炎)和omega-6(n-6，一般为促炎)脂肪酸摄入量与系统性红斑狼疮(SLE)患者预后的关系。方法采用以人群为基础的密歇根州狼疮流行病学和监测队列研究。N-3和n-6摄入量的估计值来自饮食历史问卷II项目(过去一年，包括份量版本)。患者报告的结果包括自我报告的狼疮活动(系统性狼疮活动问卷[SLAQ])。根据年龄、性别、种族和体重指数调整后的多变量回归被用来评估n-3和n-6的绝对摄入量以及n-6：n-3比率和患者报告的结果之间的关系。结果456例SLE患者中，女性425例(93.2%)，非裔美国人207例(45.4%)，平均+/-SD年龄52.9+/-12.3岁。控制潜在的混杂因素，随着n-6：n-3比例的每单位增加，平均SLAQ得分增加0.3点(95%可信区间[95%CI]0.1，0.6；P=0.013)。N-3脂肪酸每增加1克/1000千卡，狼疮活动度和患者报告的结果测量信息系统(PROIS)睡眠障碍评分均降低(SLAQ回归系数β=-0.8[95%CI-1.6，0.0]；P=0.055；PROMIS睡眠β=-1.1[95%CI-2.0，-0.2]；P=0.017)。较高的n-3摄入量与较低的抑郁症状和共病纤维肌痛水平以及较高的生活质量没有显著关系，而n6：n3比率的结果则相反。结论这项以人群为基础的研究表明，较高的n-3脂肪酸饮食摄入量和较低的n-6：n-3比率与SLE患者报告的结果密切相关，特别是自我报告的狼疮活动和睡眠质量。
Objective To examine associations between dietary intake of omega-3 (n-3; generally antiinflammatory) and omega-6 (n-6; generally proinflammatory) fatty acids and patient-reported outcomes in systemic lupus erythematosus (SLE). Methods This study was based on the population-based Michigan Lupus Epidemiology and Surveillance cohort. Estimates of n-3 and n-6 intake were derived from Diet History Questionnaire II items (past year with portion size version). Patient-reported outcomes included self-reported lupus activity (Systemic Lupus Activity Questionnaire [SLAQ]). Multivariable regression, adjusted for age, sex, race, and body mass index, was used to assess associations between absolute intake of n-3 and n-6, as well as the n-6:n-3 ratio, and patient-reported outcomes. Results Among 456 SLE cases, 425 (93.2%) were female, 207 (45.4%) were African American, and the mean +/- SD age was 52.9 +/- 12.3 years. Controlling for potential confounders, the average SLAQ score was significantly higher by 0.3 points (95% confidence interval [95% CI] 0.1, 0.6;P= 0.013) with each unit increase of the n-6:n-3 ratio. Both lupus activity and Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance scores were lower with each 1-gram/1,000 kcal increase of n-3 fatty acids (SLAQ regression coefficient beta = -0.8 [95% CI -1.6, 0.0];P= 0.055; PROMIS sleep beta = -1.1 [95% CI -2.0, -0.2];P= 0.017). Higher n-3 intakes were nonsignificantly associated with lower levels of depressive symptoms and comorbid fibromyalgia, and with higher quality of life, whereas results for the n6:n3 ratio trended in the opposite direction. Conclusion This population-based study suggests that higher dietary intake of n-3 fatty acids and lower n-6:n-3 ratios are favorably associated with patient-reported outcomes in SLE, particularly self-reported lupus activity and sleep quality.