Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire.
Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire.
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DOI：
10.1186/s12967-015-0658-y
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发表时间：
2015-09-16
影响因子：
7.4
通讯作者：
Savastano S
中科院分区：
文献类型：
--
作者：
Barrea L;Macchia PE;Tarantino G;Di Somma C;Pane E;Balato N;Napolitano M;Colao A;Savastano S
西方饮食模式是牛皮癣发病机制中的环境饮食因素之一。营养数据收集方法和性别差异可能会影响饮食和银屑病之间的联系。7天的食物记录被认为是自我管理食物频率问卷的“黄金标准”。在这项研究中，我们评估了一组银屑病患者与年龄和体重指数(BMI)匹配的对照组在饮食摄入量、人体测量和心脏代谢风险方面的差异。此外，在银屑病患者组中，我们调查了饮食摄入量与银屑病临床严重程度之间的关系。横断面病例对照观察性研究。共有82名成年男性、41名未接受治疗的银屑病患者和41名年龄和体重指数匹配的健康受试者参加了这项研究。用银屑病面积和严重程度指数(PASI)评分评估银屑病的临床严重程度。膳食访谈数据由一份7天的饮食记录收集。测量了人体测量、血糖和血脂、肝功能和C反应蛋白水平。计算稳态模型胰岛素抵抗指数(HOMA-IR)、内脏脂肪指数(VAI)和脂肪肝指数(FLI)。银屑病患者总碳水化合物、单糖、总脂肪、多不饱和脂肪酸(PUFA)和n-6/n-3PUFAs比值、胆固醇的摄入量高于对照组，而蛋白质、复合碳水化合物、单不饱和脂肪酸(MUFA)、n-3PUFA和纤维的摄入量低于对照组。此外，银屑病患者的人体测量、血糖和血脂谱、肝功能测试以及HOMA-IR、VAI和FLI值升高。除蛋白质和总碳水化合物外，PASI评分与人体测量、血糖和血脂、肝功能测试、心脏代谢指数和饮食成分有很好的相关性。在PASI评分和MUFA之间的Logistic回归分析中，只有较高的PASI评分才能很好地预测METS的存在(OR=1.794；P=0.002；CI 1.242~2.591)。多元回归分析显示，多不饱和脂肪酸对PASI评分的预测效果最好(R2=0.387，β=−0.635，t=−=5.127，P<0.001)。成年男性银屑病患者的饮食摄入量与对照组相比有差异。这些差异与牛皮癣的严重程度和心脏代谢风险有关。FLI代表了银屑病患者心脏代谢风险的早期指标，饮食中的MUFA是银屑病临床严重程度的主要预测因子，而银屑病和代谢综合征之间的关联似乎与MUFA的摄入量无关。低MUFA消耗量可能是增加银屑病患者炎症环境的一种可能的辅助机制。
Western dietary pattern is included among the environmental dietary factors involved in the pathogenesis of psoriasis. Nutritional data collection methods and gender differences might affect the association between diet and psoriasis. The 7-day food records is considered the “gold standard” of self-administered food frequency questionnaires. In this study, we evaluated the differences in the dietary intake, anthropometric measurements and cardio-metabolic risk profile in a group of psoriatic patients compared with an age and Body Mass Index (BMI)-matched control group. In addition, in the group of psoriatic patients we investigated the association between the dietary intake and clinical severity of psoriasis. Cross-sectional case control observational study. A total of 82 adult males, 41 treatment-naïve patients with psoriasis and 41 healthy subjects matched for age and BMI were included in the study. The clinical severity of psoriasis was by assessed by Psoriasis Area and Severity Index (PASI) score. The dietary interview data were collected by a 7-day food records. Anthropometric measures, glucose and lipid profile, liver function tests and C-reactive protein levels were measured. Homeostasis Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI) and the Fatty Liver Index (FLI) were calculated. Psoriatic patients consumed a higher percentage of total and simple carbohydrates, total fat, polyunsaturated fatty acid (PUFA) and n-6/n-3 PUFAs ratio, and cholesterol, while the consumption of protein, complex carbohydrates, monounsaturated fatty acid (MUFA), n-3 PUFA and fiber was lower than in the control group. In addition, psoriatic patients presented altered anthropometric measurements, glucose and lipid profile, liver function tests, and elevated values of HoMA-IR, VAI and FLI. PASI score well correlated with anthropometric measures, glucose and lipid profile, liver function tests, cardio-metabolic indices, and the dietary components, except for protein and total carbohydrates. At logistic regression analysis between PASI score and MUFA, MetS presence was well predicted only by higher PASI score (OR = 1.794; p = 0.002; CI 1.242–2.591). At multiple regression analysis, MUFA was the best predictor of PASI score (r2 = 0.387, β = −0.635, t = −5.127, p < 0.001). Differences in dietary intake were observed in adult male psoriatic patients compared with the controls. These differences were associated to the severity of the psoriasis and cardio-metabolic risk. FLI represented an early indicator of the cardio-metabolic risk profile in psoriatic patients, and dietary MUFA were major predictor of the clinical severity of psoriasis, while the association between psoriasis and metabolic syndrome appeared to be independent of MUFA intake. The low MUFA consumption might act as a possible adjunctive mechanism in increasing the inflammation milieu of psoriatic patients.