Dietary n-3 fats and outcomes in early-onset rheumatoid arthritis

有相当多的证据表明，增加omega-3多不饱和脂肪的饮食摄入量对健康有积极的好处。在类风湿性关节炎、其他炎症性疾病和心脏病方面也有好处。之前关于类风湿性关节炎和饮食omega-3脂肪的研究有一个共同的设计，这可能会减少有益的饮食影响的幅度。因此，需要进行一项“第二代”研究，解决这些常见的设计问题，以确定饮食中使用omega-3脂肪治疗类风湿性关节炎的最佳条件。目前的提案将通过改变背景饮食、测量功能残疾和关节损伤以及症状、在关节损伤发生之前开始早期疾病治疗以及通过规范同时使用药物来解决以前的设计缺陷。这项研究还将评估一种新的血液测试，该测试表明建议增加饮食中的omega-3脂肪对omega-3营养状态的影响。如果这一营养指数与更有利的结果相关，将为指导常规临床情况下使用omega-3脂肪的治疗奠定基础。这项研究很重要，因为饮食治疗类风湿性关节炎：(A)使类风湿性关节炎患者在其疾病的终身管理中发挥更积极的作用。(B)对政府卫生预算没有持续成本，事实上，有可能大幅降低类风湿性关节炎的治疗成本(C)具有更广泛的适用性，例如，用于预防和治疗其他炎症状况和心脏病(D)需要通过现代治疗方案进行测试，这些方案涉及在类风湿性关节炎病程早期开始的多种疗法，在不可逆转的损害和残疾发生之前(E)需要营养指数来指导治疗(F)必须有证据。

There is considerable evidence that positive health benefits flow from increasing the dietary intake of omega-3 polyunsaturated fats. Benefits are seen in rheumatoid arthritis, other inflammatory disorders and heart disease. Previous studies of rheumatoid arthritis and dietary omega-3 fats had a common design which probably reduced the magnitude of the beneficial dietary effects. Therefore, a 'second generation' study is needed which addresses these common design issues in order to establish optimal conditions for the use of dietary omega-3 fats in therapy for rheumatoid arthritis. The current proposal will address the previous design shortcomings by changing the background diet, measuring functional disability and joint damage as well as symptoms, starting treatment in early disease before joint damage has occurred, and by regulating concurrent drug use. The study will also evaluate a novel blood test that indicates the effect of advice to increase dietary omega-3 fats upon omega-3 nutritional status. If this nutritional index correlates with more favourable outcomes, a base will have been established for guiding treatment with omega-3 fats in routine clinical situations. This study is important because dietary treatment in rheumatoid arthritis: (a) offers sufferers with rheumatoid arthritis a more active role in the life long management of their disease. (b) has no on-going cost to the government health budget, and in fact, has the potential to decrease treatment costs in rheumatoid arthritis considerably (c) has wider applicability, e.g. for prevention and treatment of other inflammatory conditions and heart disease (d) needs to be tested with modern treatment protocols that involve multiple therapies started early in the course of rheumatoid arthritis, before irreversible impairment and disability has occurred (e) requires a nutritional index to guide treatment (f) must be evidence based.