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Plasma phospholipid fatty acid content is related to disease activity in ankylosing spondylitis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
School of social and health sciences, Halmstad university, Halmstad, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
Division of clinical nutrition and metabolism, department of public health and caring science, Uppsala university, Uppsala, Sweden.
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2012 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 39, no 2, 327-333 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate the fatty acid composition in the diet, plasma phospholipids, and adipose tissue among a cohort of patients with ankylosing spondylitis (AS), and to determine their correlation to disease activity and blood lipids in a cross-sectionally designed study.

Methods: Diet was assessed using a food frequency questionnaire on 66 patients with AS. The polyunsaturated fatty acids (PUFAs) in plasma phospholipids and gluteal adipose tissue were measured using gas chromatography. Disease status was quantified using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein and pro-inflammatory cytokines.

Results: Diet did not correlate to disease activity assessed by the BASDAI, but there were negative correlation between the dietary intake of long-chained omega-3 fatty acids and ESR (rs=-0.27, p<0.05). The plasma phospholipid content of arachidonic acid (AA) correlated significantly with the BASDAI score (rs=0.39, p<0.01). There were correlations between the intake of long-chained omega-3 fatty acids and high-density lipoproteins as well as to serum triglycerides (rs=0.26 and rs=-0.25; respectively, p<0.05).

Conclusion: There was a positive correlation between levels of AA in plasma phospholipids and disease activity assessed by BASDAI in patients with AS. A western diet does not appear to influence this correlation, but seems to affect blood lipids involved in atherogenic processes. 

Place, publisher, year, edition, pages
Toronto: Journal of Rheumatology Pub. Co. , 2012. Vol. 39, no 2, 327-333 p.
Keyword [en]
ankylosing spondylitis, disease activity, fatty acids, diet
National Category
Rheumatology and Autoimmunity
Research subject
Medicine, rheumatology
Identifiers
URN: urn:nbn:se:umu:diva-48556DOI: 10.3899/jrheum.110575OAI: oai:DiVA.org:umu-48556DiVA: diva2:451476
Available from: 2011-10-26 Created: 2011-10-22 Last updated: 2017-12-08Bibliographically approved
In thesis
1. On diet in ankylosing spondylitis
Open this publication in new window or tab >>On diet in ankylosing spondylitis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to examine the role of diet in ankylosing spondylitis (AS). Patients were examined in: i) a postal questionnaire survey of dietary habits and gastrointestinal (GI) symptoms; ii) a study on biomarkers of diet and disease activity; iii) a comparison of cardiovascular risk factors with the general population using data from the Västerbotten Intervention Programme (VIP), and; iv) a 21-week omega-3 fatty acid supplementation study regarding the effects on disease activity.

The postal survey (111 respondents) revealed no correlation between dietary habits and disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). However, GI problems, and in particular GI pain, were prevalent in patients with AS irrespective of NSAID usage.Gastrointestinal pain was predicted by higher BASDAI and a higher consumption of vegetables. Overall, 30 (27%) of the patients experienced an aggravation of gastric symptoms when consuming certain foods. In the study of biomarkers (n=66) no correlation was found between diet and disease activity as assessed by BASDAI. There were, however, positive correlations between BASDAI and the content of arachidonic acid (AA) in plasma phospholipids (rs=0.39, p<0.01) and the estimated activity of the enzyme delta-5-desaturase (rs=0.37, p<0.01). This may reflect a process involved in the inflammation associated with AS that requires further investigation. Comparing data from the VIP for patients (n=89) and controls showed no significant differences regarding diet, physical activity or smoking. Nonetheless, more pronounced correlations between blood lipids and diet were identified among patients than in controls. Furthermore, the levels of cholesterol and triglycerides were lower in patients compared with controls. Lastly, in the supplementation study, a high-dose of long-chain omega-3 fatty acids (4.55 grams/day) was found to lower disease activity, as measured by BASDAI, whereas low-dose treatment (1.95 grams/day) caused no change.

In conclusion, within a group of Swedish AS patients we found no correlation between ordinary dietary habits and disease activity. Diet in western populations of patients with AS may, however, be of importance for gastric symptoms and for cardiovascular risk factors. The finding of a lowered disease activity in patients on high-dose supplementation with long-chain omega-3 fatty acids indicates that a radical dietary shift may influence disease activity. The findings of a positive correlation between disease activity and plasma AA, and the decreased levels of blood lipids imply the need for further studies into fatty acid metabolism in AS. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 50 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1440
Keyword
diet, ankylosing spondylitits, omega-3, cardiovascular
National Category
Rheumatology and Autoimmunity
Research subject
Medicine, rheumatology
Identifiers
urn:nbn:se:umu:diva-48557 (URN)978-91-7459-272-6 (ISBN)
Public defence
2011-11-18, Utbildningsnod XI, lokal 135, Umeå Universitet, UMEÅ, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-10-28 Created: 2011-10-22 Last updated: 2011-10-28Bibliographically approved

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