Serum Fatty Acid Profiles Are Associated with Disease Activity in Early Rheumatoid Arthritis: Results from the ESPOIR Cohort

Abstract

Background: Long-chain omega-3 and omega-6 fatty acids (n-3, n-6 FAs) may modulate inflammation and affect the risk of developing rheumatoid arthritis (RA). However, whether n-3/n-6 FA status affects RA after disease onset is unknown. This study aimed to assess whether FA profiles are independently associated with disease activity in a large prospective cohort of patients with early RA. Methods: Baseline serum FAs were quantified in 669 patients in the ESPOIR cohort. Principal component analysis identified three serum FA patterns that were rich in n-7–9, n-3 and n-6 FAs (patterns ω7–9, ω3 and ω6), respectively. The association of pattern tertiles with baseline variables and 6-month disease activity was tested using multivariable logistic regression. Results: Pattern ω3 was associated with low baseline and pattern ω6 with high baseline C-reactive protein level and disease activity. Both patterns ω3 and ω6 were associated with reduced odds of active disease after 6 months of follow-up (pattern ω3: odds ratio, tertile three vs. one, 0.49 [95% CI 0.25 to 0.97] and pattern ω6: 0.51 [0.28 to 0.95]; p = 0.04 and 0.03, respectively). Conclusions: In a cohort of early RA patients, a serum lipid profile rich in n-3 FAs was independently associated with persistently reduced disease activity between baseline and 6-month follow-up. An n-6 FA profile was also associated with lower 6-month disease activity.

Does Dietary Polyunsaturated Fatty Acid Intake Associate With Bone Mineral Density and Limb Structural Changes in Early Rheumatoid Arthritis?

“…This result is in line with a previous finding demonstrating PUFAs to have a positive effect on BMD. [15][16][17][18][19]21,22 As oxidative damage has been found to be significantly noticeable in RA patients, 39 diet rich in PUFAs could be beneficial in ERA for preventing a reduction of BMD. Still, in our ERA subjects, the association may have been weaker, as the ERA subjects consumed less fats compared with controls.…”

“…The variables were chosen, as they can possibly associate with BMD changes. 7,[15][16][17][18][19]21,22,28 Multiple regression analysis (adjusted for age, gender, height, and weight) was carried out both in ERA and control subjects to evaluate if dietary intake of PUFAs was associated with arm and leg structural (fat, lean mass) changes. Additional analysis of the ERA and control group females (adjusted for age, height, and weight) was done to diminish gender related body structure differences.…”

“…7 Omega-3 PUFA supplementation has been found to reduce pain, morning stiffness in RA, the frequency of nonsteroidal anti-inflammatory drug (NSAID) consumption, 15,16 and has been associated with lower disease-activity-related markers. [17][18][19] In France, PUFA supplementation is already an official recommendation to RA patients for symptomatic relief. 20 The main dietary sources of omega-6 PUFAs are vegetable oils and animal sources.…”

Lipid metabolism and rheumatoid arthritis

“…In addition to drug treatment, diet also has beneficial or harmful effects on RA. Overall, energy intake, total FA and saturated FA, the unbalanced ratio of n-3 to n-6 FA, and the western type diet characterized by a high sugar diet, low fiber, and low antioxidant content can increase obesity, thereby increasing the risk of RA ( 142 , 143 ). Therefore, dietary intervention strategy in RA is also a hot spot in RA research.…”

Langkettige Omega-3-Fettsäuren EPA und DHA

“…waren höhere Werte von Serum-Omega-3-Fettsäuren mit einer verminderten Krankheitsaktivität assoziiert [16].…”