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中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 51 -56. doi: 10.3877/cma.j.issn.1674-134X.2021.01.009

所属专题: 文献

临床论著

中年女性亚油酸摄入与类风湿性关节炎的相关性
王瑜孜1,(), 金心2, 袁幼红1   
  1. 1. 443000 宜昌市妇幼保健院检验科
    2. 443000 宜昌,葛洲坝中心医院检验科
  • 收稿日期:2019-08-28 出版日期:2021-02-01
  • 通信作者: 王瑜孜

Study on relationship between linoleic acid intake and rheumatoid arthritis

Yuzi Wang1,(), Xin Jin2, Youhong Yuan1   

  1. 1. Department of Clinical Laboratory, Yichang Maternal and Child Health Hospital, Yichang 443000, China
    2. Department of Clinical Laboratory, Gezhouba Central Hospital, Yichang 443000, China
  • Received:2019-08-28 Published:2021-02-01
  • Corresponding author: Yuzi Wang
引用本文:

王瑜孜, 金心, 袁幼红. 中年女性亚油酸摄入与类风湿性关节炎的相关性[J/OL]. 中华关节外科杂志(电子版), 2021, 15(01): 51-56.

Yuzi Wang, Xin Jin, Youhong Yuan. Study on relationship between linoleic acid intake and rheumatoid arthritis[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(01): 51-56.

目的

研究中年女性每日膳食亚油酸摄入量与类风湿性关节炎(RA)的关系。

方法

本研究数据来自美国妇女健康研究(SWAN)1996~1997年基线数据。纳入标准:近3个月内没有使用性激素;近3个月内月经出血;目前没有怀孕或哺乳;子宫完整,卵巢至少1个;42~52岁女性。排除饮食信息和疾病信息不全的研究对象。类风湿性关节炎的诊断来自研究对象填写的问卷报告。膳食信息由1995年版饮食频率调查问卷得出。患有类风湿性关节炎的研究对象被纳入关节炎组(n=627),其余研究对象纳入对照组(n=2 494)。Mann-Whitney U检验比较关节炎组和对照组均值的差异,卡方检验比较率的差异,logistic回归分析膳食亚油酸与RA之间的关系,限制性3次样条分析非线性关系。

结果

在3 121例研究对象中,有627例(20.09%)患有类风湿性关节炎。关节炎组的亚油酸摄入量高于对照组(Z=-2.403,P=0.016)。在未调整协变量的模型中,亚油酸摄入量与RA呈正相关关系;这种关系在调整了年龄、种族/名族、教育程度、吸烟、平均运动指数、经期状态、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇后仍然存在,调整后的比值比(OR)及其95%置信区间(CI)为1.597(1.211,2.107)。限制性3次样条回归表明亚油酸摄入量与类风湿性关节炎风险呈现为逐渐升高的"折线型"。多因素分析表明,年龄、甘油三酯、低密度脂蛋白胆固醇和亚油酸摄入量与RA风险呈正相关[OR=1.051,95% CI(1.014,1.089);OR=1.004,95% CI(1.002,1.006);OR=1.013,95% CI(1.005,1.022);OR=1.009,95% CI(1.002,1.017);均为P<0.05]。教育程度、平均运动指数、经期状态、总胆固醇与RA风险呈负相关[OR=0.870,95% CI(0.803,0.944);OR=0.878,95% CI(0.785,0.981);OR=0.723,95% CI(0.596,0.877);OR=0.986,95% CI(0.978,0.994);均为P<0.05]。

结论

亚油酸的摄入与RA的发生呈正相关,RA的预防和管理可将膳食亚油酸作为切入点。

Objective

To study the relationship between daily linoleic acid intake and rheumatoid arthritis (RA).

Methods

Data were obtained from the Study of Women's Health Across the Nation (SWAN) 1996-1997 baseline data.Women who met the eligibility criteria were 42~52 years old, had an intact uterus and at least one intact ovary, had not used reproductive hormones in the previous three months and had at least one menstrual period. Women were excluded due to missing information regarding diet and RA. Women suffered from RA and were classified as arthritis group, the rest were classified as control group. Dietary intake was estimated through the 1995 Dietary Frequency Questionnaire. Mann-Whitney U test was used to compare the difference of mean values between groups. Chi-square test was performed to compare differences of rate between groups. Logistic regression analysis were used to exam the relationship between dietary linoleic acid and RA. Restrictive cubic spline analysis was performed to exam non-linear relationships.

Results

Among the 3 121 subjects, 627 (20.09%) suffered from RA.Compared with the control group, the arthritis group had higher linoleic acid intake (Z=-2.403, P=0.016). In the unadjusted covariate model, linoleic acid intake was positively correlated with RA. This relationship still existed in Model 1, which adjusted socio-economic factors. After fully adjusting the socioeconomic and clinical factors, linoleic acid intake was positively correlated with RA risk [ odds ratio(OR)=1.597, 95% confidence interval(CI) (1.211, 2.107)] for the highest quartile spacing compared with the lowest quartile spacing. Restricted cubic spline regression showed that linoleic acid intake and the risk of rheumatoid arthritis presented as polyline-shape. Multivariate analysis showed that age, triglyceride, LDL-C and linoleic acid intake were positively correlated with prevalence of RA [OR=1.051, 95% CI(1.014, 1.089), OR=1.004, 95% CI(1.002, 1.006), OR=1.013, 95% CI(1.005, 1.022), OR=1.009, 95% CI(1.002, 1.017), all P<0.05]. Education level, average exercise index, menstrual state and total cholesterol were negatively correlated with prevalence of RA [OR=0.870, 95% CI(0.803, 0.944), OR=0.878, 95% CI(0.785, 0.981), OR=0.723, 95% CI(0.596, 0.877), OR=0.986, 95% CI(0.978, 0.994), all P<0.05].

Conclusion

The intake of linoleic acid is positively correlated with the RA. Linoleic acid serves as a point of breakthrough in the prevention and treatment of RA.

表1 两组患者临床资料对比
表2 每日膳食亚油酸摄入量与类风湿性关节炎的logistic回归
图1 每日膳食亚油酸摄入量与类风湿性关节炎风险的非线性关系
表3 RA风险的多因素分析
[1]
王国华. 类风湿关节炎免疫发病机制研究进展[J]. 中国组织化学与细胞化学杂志,2010,19(3):309-312.
[2]
付迪,谢颖颖,肖楚吟,等.沙立度胺用于类风湿性关节炎的疗效及对趋化因子配体的影响[J/CD].中华关节外科杂志(电子版),2017,11(6):617-621.
[3]
黄燹,向阳.类风湿关节炎的饮食干预[J].湖北民族学院学报(医学版),2018,35(4):58-62.
[4]
杜欢,许霞. 近5年来类风湿关节炎发病机制研究进展[J]. 辽宁中医药大学学报,2015,17(10):77-80.
[5]
陆意,邵传森. 类风湿关节炎发病机制的研究进展[J]. 国际免疫学杂志,2001,24(5):256-258.
[6]
Pattison DJ, Symmons DP, Lunt M, et al. Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption[J]. Arthritis Rheum, 2004, 50(12): 3804-3812.
[7]
Maxwell JR, Gowers IR, Moore DJ, et al. Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis[J]. Rheumatology (Oxford), 2010, 49(11): 2140-2146.
[8]
Scrivo R, Massaro L, Barbati C, et al. The role of dietary sodium intake on the modulation of T helper 17 cells and regulatory T cells in patients with rheumatoid arthritis and systemic lupus erythematosus[J/OL]. PLoS One, 2017, 12(9): e0184449. doi: 10.1371/journal.pone.0184449.
[9]
校宏兵,曹伟新,尹浩然,等. 全肠道外营养脂肪能源的选择和应用[J]. 中华临床营养杂志,1996,(4):30-33.
[10]
Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies[J]. Am J Clin Nutr, 1982, 36(5): 936-942.
[11]
Seo SK, Choi JH, Kim YH, et al. 4-1BB-mediated immunotherapy of rheumatoid arthritis[J]. Nat Med, 2004, 10(10): 1088-1094.
[12]
Forsyth C, Kouvari M, D'Cunha NM, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies[J]. Rheumatol Int, 2018, 38(5): 737-747.
[13]
Tedeschi SK, Costenbader KH. Is there a role for diet in the therapy of rheumatoid arthritis?[J/OL]. Curr Rheumatol Rep, 2016, 18(5): 23. doi: 10.1007/s11926-016-0575-y.
[14]
Petersson S, Philippou E, Rodomar C, et al. The Mediterranean diet, fish oil supplements and rheumatoid arthritis outcomes: evidence from clinical trials[J]. Autoimmun Rev, 2018, 17(11): 1105-1114. doi: 10.1016/j.autrev.2018.06.007.
[15]
Tedeschi SK, Frits M, Cui J, et al. Diet and rheumatoid arthritis symptoms: survey results from a Rheumatoid Arthritis Registry[J]. Arthritis Care Res (Hoboken), 2017, 69(12): 1920-1925.
[16]
Johansson K, Askling J, Alfredsson L, et al. Mediterranean diet and risk of rheumatoid arthritis: a population-based case-control study [J/OL]. Arthritis Res Ther, 2018, 20(1): 175. doi: 10.1186/s13075-018-1680-2.
[17]
Sundström B, Johansson I, Rantapää-Dahlqvist S. Diet and alcohol as risk factors for rheumatoid arthritis: a nested case-control study[J]. Rheumatol Int, 2015, 35(3): 533-539.
[18]
Samuels JS, Holland L, López M, et al. Prostaglandin E2 and IL-23 interconnects STAT3 and RoRγ pathways to initiate Th17 CD4(+) T-cell development during rheumatoid arthritis[J]. Inflamm Res, 2018, 67(7): 589-596.
[19]
Moghaddam MF, Grant DF, Cheek JM, et al. Bioactivation of leukotoxins to their toxic diols by epoxide hydrolase[J]. Nat Med, 1997, 3(5): 562-566.
[20]
Hennig B, Lei W, Arzuaga X, et al. Linoleic acid induces proinflammatory events in vascular endothelial cells via activation of PI3K/Akt and ERK1/2 signaling [J]. J Nutr Biochem, 2006, 17(11): 766-772.
[21]
Schübel R, Jaudszus A, Krüger R, et al. Dietary essential α-linolenic acid and linoleic acid differentially modulate TNFα-induced NFκB activity in FADS2-deficient HEK-293 cells[J]. Int J Food Sci Nutr, 2017, 68(5): 553-559.
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