Diet and fatty acid pattern among patients with SLE: associations with disease activity, blood lipids and atherosclerosis

• Published in: Lupus Vol. 21; no. 13; pp. 1405 - 1411
• Main Authors: Elkan, A-C, Anania, C, Gustafsson, T, Jogestrand, T, Hafström, I, Frostegård, J
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.11.2012; Sage Publications Ltd
• Subjects: Abdomen; Abdominal Fat - metabolism; Adipocytes; Adipose tissue; Apolipoprotein A-I - blood; Arteriosclerosis; Atherosclerosis; Blood; Body fat; Carbohydrates; Cardiovascular disease; Carotid arteries; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Artery Diseases - blood; Carotid Artery Diseases - diagnosis; Carotid Intima-Media Thickness; Case-Control Studies; CD95 antigen; Cross-Sectional Studies; Diet; Dietary Carbohydrates - metabolism; Dietary Fats - blood; Dietary Fiber - metabolism; Diets; Docosahexaenoic acid; Eicosapentaenoic acid; Energy Intake; Fas antigen; Fatty acids; Fatty Acids - blood; Feeding Behavior; Female; Food; Humans; Inventories; Lipids; Lupus; Lupus Erythematosus, Systemic - blood; Lupus Erythematosus, Systemic - diagnosis; Male; Medicin och hälsovetenskap; Middle Aged; Plaque, Atherosclerotic; Plaques; Questionnaires; Rheumatic diseases; Rheumatology; Serum lipids; Severity of Illness Index; Surveys and Questionnaires; Systemic lupus erythematosus; Ultrasonography, Doppler, Duplex; Ultrasound; Sweden; cardiovascular disease; Systemic lupus erythematosus (SLE); diet; fatty acids
• ISSN: 0961-2033; 1477-0962; 1477-0962
• DOI: 10.1177/0961203312458471

Objective: As atherosclerosis is increased in systemic lupus erythematosus (SLE) we compared dietary habits in patients with SLE with controls, and in the patients studied associations of diet components, especially fatty acids (FAs), with disease activity, serum lipids and carotid plaque presence. Methods: In all 114 patients with SLE and 122 age- and sex-matched population-based controls answered a food frequency questionnaire (FFQ). Subcutaneous abdominal fat cell aspiration was analysed as to FA content and plaque occurrence was determined by B-mode ultrasound. Results: The total diet energy intake did not differ between patients and controls. However, the patients with SLE reported a higher intake of carbohydrate, lower fibre intake and lower intake of omega-3 and omega-6, than controls (p < 0.05). In the patients, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in adipose tissue (AT) correlated negatively with disease activity (SLEDAI), r = −0.36, p = <0.001 and r = −0.33, p = < 0.001, respectively. AT omega-3 was further positively associated with serum apoA1, r = 0.29, p = 0.004, whereas AT omega-6 showed a negative association, r = −0.21, p = 0.040. These FAs also had opposite associations with plaque presence, EPA and were DHA negative, r = −0.32, p = 0.002 and r = −0.33, p = 0.001, respectively, and omega-6 positive, r = 0.22, p = 0.027. The carbohydrate intake was positively correlated to AT omega-6, r = 0.38, p < 0.001, and negatively with serum apoA1, r = −0.27, p = 0.005. Conclusion: The macronutrient dietary pattern is different in SLE as compared with controls. The low intake of omega-3 and high intake of carbohydrate among patients with SLE appear to be associated with worse disease activity, adverse serum lipids and plaque presence.