The association between omega-3 fatty acid biomarkers and inflammatory arthritis in an anti-citrullinated protein antibody positive population

• Published in: Rheumatology (Oxford, England) Vol. 56; no. 12; pp. 2229 - 2236
• Main Authors: Gan, Ryan W, Bemis, Elizabeth A, Demoruelle, M Kristen, Striebich, Christopher C, Brake, Stacey, Feser, Marie L, Moss, LauraKay, Clare-Salzler, Michael, Holers, V Michael, Deane, Kevin D, Norris, Jill M
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.12.2017
• Subjects: Anti-Citrullinated Protein Antibodies - blood; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - epidemiology; Autoantibodies - blood; Basic and Translational Science; Biomarkers - blood; Colorado; Epitopes; Fatty Acids, Omega-3 - blood; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Odds Ratio; Peptides, Cyclic - immunology; Proportional Hazards Models; Rheumatoid Factor - blood; Risk Factors; Survival Analysis; epidemiology; autoantigens and autoantibodies; autoinflammatory conditions; rheumatoid arthritis; diet therapy
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/kex360

Higher circulating omega-3 fatty acids (n-3 FAs) are associated with a lower prevalence of anti-CCP antibodies and RF in subjects without RA. We examined whether, in anti-CCP+ subjects, n-3 FAs also play a role in development of inflammatory arthritis (IA). At Colorado-based health fairs from 2008 to 2014, participants without a previous diagnosis of RA who were anti-CCP3+ (n = 47) were recruited into a follow-up study; symptom assessments and joint examinations were conducted every 6 months for the determination of IA. We measured n-3 FAs as a percentage of total lipids in red blood cell membranes (n-3 FA%) at each visit. We detected IA in 10 anti-CCP3+ subjects (21%) at the baseline visit. Increased total n-3 FA% in red blood cell membranes [odds ratio (OR) = 0.09, 95% CI: 0.01, 0.76], specifically docosapentaenoic acid (OR = 0.16, 95% CI: 0.03, 0.83) and docosahexaenoic acid (OR = 0.23, 95% CI: 0.06, 0.86), was associated with a lower odds of IA at the baseline visit, adjusting for n-3 FA supplement use, current smoking, RF+, elevated CRP+ and shared epitope. We followed 35 of the anti-CCP3+ subjects who were IA negative at baseline and detected 14 incident IA cases over an average of 2.56 years of follow-up. In a time-varying survival analysis, increasing docosapentaenoic acid significantly decreased risk of incident IA (hazard ratio = 0.52, 95% CI: 0.27, 0.98), adjusting for age at baseline, n-3 FA supplement use, RF+, CRP+ and shared epitope. n-3 FAs may potentially lower the risk of transition from anti-CCP positivity to IA, an observation that warrants further investigation.