Diet Quality and High-Sensitivity C-Reactive Protein in Patients With Systemic Lupus Erythematosus

Abstract

Background and Aims: C-reactive protein (CRP) is commonly used as a biomarker for inflammation. Mild elevations of CRP have been seen in chronic autoimmune diseases like systemic lupus erythematosus (SLE), and CRP has been linked to an increased risk of cardiovascular events. Diet quality and certain dietary factors seem to influence CRP levels in healthy subjects. To date, the effect of diet on serum CRP in SLE has not been studied. Our aim was to investigate the relationship between dietary nutrients, antioxidant intake, and serum CRP in SLE. Design and Method: A cross-sectional study was conducted among 91 patients with SLE. High-sensitivity hsCRP values were determined using an immuno-turbidimetry assay in a Beckman Coulter analyzer (AU5800). Dietary intake of macro- and micronutrients was assessed through a 24-hr diet recall. Antioxidant nutrient intake was evaluated using the dietary antioxidant quality score (DAQs). Linear regression models were used to investigate the relationships between serum hsCRP levels, dietary nutrient intake, and DAQs. Results: The mean serum hsCRP level observed (3.76 ± 6.68 mg/L) was above the established normal range. However, participating SLE patients had low-quality diets, and we found no significant correlations between dietary intake of macro- or micronutrients or antioxidant nutrient intake (DAQs) and serum CRP levels. Conclusion: Our study reveals that participating SLE patients had a low-quality diet that did not influence inflammatory status measured using serum CRP levels. Further interventional studies with high-quality diets in this population are necessary to dissect the role of diet on CRP levels in SLE.

Erythrocyte membrane polyunsaturated fatty acid profiles are associated with systemic inflammation and fish consumption in systemic lupus erythematosus: a cross-sectional study

“…7 This seems especially concerning, since SLE patients tend to follow an unhealthy diet. 16,17 In the present study, we focused on PUFA and assessed PUFA status by both FFQ and erythrocyte membrane PUFA composition, which arguably more accurately reflects nutritional status than FFQ due to recall errors and social desirability bias. 5 PUFA represent an interesting class of macronutrients in this regard, as their intake is highly dependent upon nutrition and may differentially influence health and inflammation.…”

“…However, subclinical inflammation assessed by variations of serum CRP levels in predominantly ‘normal’ ranges have previously been linked to relevant clinical parameters such as disease activity and surrogate markers for atherosclerosis in SLE patients. 17,19 Previous interventional studies which administered omega-3 PUFA containing fish oil to SLE patients produced conflicting results in this regard: amelioration of systemic inflammatory markers was seen in some 20,21 but not all studies. 22,23 Of note, individual nutrition status omega-3 PUFA content in the blood cells was not assessed in these studies.…”

Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

“…Apigenin (a mutagenic flavonoid rich in parsley, thyme, peppermint, olives and chamomile) inhibited autoantigen presentation and stimulatory functions of antigen-presenting cells necessary for activation and expansion of autoreactive Th1 and Th17 cells ( Figure 2 ) and B cells in SLE by downregulation of COX-2 expression ( 195 ). Nevertheless, Pocovi-Gerardino et al ( 196 ) documented no significant correlation between the dietary intake of macronutrients, micronutrients or antioxidants, and serum levels of CRP in patients with SLE.…”