scholarly journals The change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

2020 ◽  
Author(s):  
Yoshinari Matsumoto ◽  
Nitin Shivappa ◽  
Yuko Sugioka ◽  
Masahiro Tada ◽  
Tadashi Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Quantitative Measure ◽  
Significant Negative Correlation ◽  
Change Score ◽  
Multivariable Logistic Regression Analysis ◽  
Dietary Inflammatory Index ◽  
Cross Sectional ◽  
Inflammatory Index ◽  
Rheumatoid Arthritis Disease

Abstract Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, to the best of our knowledge, there is no report which investigated the association between rheumatoid arthritis (RA) and DII. Therefore, we investigate the association between the DII and disease activity in patients with RA.Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a 10-year prospective cohort study consisting of 208 RA patients and 205 gender- and age-matched non-RA controls recruited in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DIITM) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). E-DII score showed statistically significant negative correlation with age in RA patients, both in 2011 (r = -0.20) and 2017 (r = -0.23). Controls also showed a similar trend. In RA patients, E-DII score was not a factor associated with disease activity in a cross-sectional analysis. However, decline in E-DII (anti-inflammatory change) score was a factor that increased the odds of maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR: 4.33, 95%CI: 1.66-11.29, p = 0.003).Conclusions E-DII score was high in RA patients and lowering E-DII score over time may be beneficial in controlling disease activity in patients with RA.Trial registration UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/, UMIN000003876. Registered 7 Aug 2010 - Retrospectively registered.

scholarly journals Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yoshinari Matsumoto ◽  
Nitin Shivappa ◽  
Yuko Sugioka ◽  
Masahiro Tada ◽  
Tadashi Okano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Quantitative Measure ◽  
Inflammatory Change ◽  
Multivariable Logistic Regression Analysis ◽  
Dietary Inflammatory Index ◽  
Low Disease Activity ◽  
Inflammatory Index ◽  
Rheumatoid Arthritis Disease ◽  
Anti Inflammatory

Abstract Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA. Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a cohort study consisting of 208 RA patients and 205 gender- and age-matched controls started in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DII™) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results One hundred and seventy-seven RA patients and 183 controls, for whom clinical and dietary survey data were available, were analyzed. RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). In RA patients, E-DII score was not a factor associated with significant change in disease activity. However, anti-inflammatory change in E-DII score was associated maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR 3.46, 95% CI 0.33–8.98, p = 0.011). Conclusions The diets of RA patients had a higher inflammatory potential than controls. Although E-DII score was not a factor associated with significant disease activity change, anti-inflammatory change in E-DII score appeared to be associated with maintaining low disease activity in patients with RA. Trial registration UMIN Clinical Trials Registry, UMIN000003876. Registered 7 Aug 2010—retrospectively registered.

scholarly journals Associations Between Dietary Inflammatory Index Scores And The Increased Disease Activity of Rheumatoid Arthritis: A Cross-Sectional Study

2021 ◽  
Author(s):  
Atiyeh Nayebi ◽  
Davood Soleimani ◽  
Shayan Mostafaei ◽  
Negin Elahi ◽  
Naseh Pahlavani ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Mean Difference ◽  
Fat Free Mass ◽  
P Value ◽  
Dietary Inflammatory Index ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inflammatory Index

Abstract Background: Diet plays an important role in regulating inflammation, which is a hallmark of rheumatoid arthritis (RA). Our aim was to investigate the association between the inflammatory potential of diet and RA activity.Methods: This cross-sectional study was conducted on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall inflammatory potential of the diet was extracted from a validated 168-item food frequency questioner (FFQ) using the Dietary Inflammatory Index (DII). RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. Logistic regression and one-way ANOVA/ ANCOVA were conducted. Results: Individuals in the highest DII quartile had the significantly higher odds of positive C-reactive protein (CRP) than those in the lowest quartile of the DII scores (OR: 4.5; 95% CI: 1.16 – 17.41; P-value: 0.029). A statistically significant downward linear trend in fat-free mass and weight were observed with increasing the DII quartiles (P-value=0.003, P-value=0.019, respectively). Patients in the highest DII quartile had higher DAS 28 scores than those in the first quartile (Mean difference: 1.16; 95% CI: 0.51 – 1.81; P-value <0.001) and second quartile of the DII scores (Mean difference: 1.0; 95% CI: 0.34 – 1.65; P-value <0.001).Conclusion: Our results indicated that reducing inflammation through diet might be one of the therapeutic strategies to control and reduce the disease activity in RA patients.

scholarly journals AB1253 EVALUATION OF CYSTEINE-RICH 61 IN RHEUMATOID ARTHRITIS AS A DIAGNOSTIC MARKER AND PREDICTOR OF ATHEROSCLEROSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1918.2-1918
Author(s):  
H. A. Esaily ◽  
D. M. Serag ◽  
M. S. Rizk ◽  
A. Sonbol ◽  
D. Salem
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Vascular Complications ◽  
Area Under The Curve ◽  
Intima Media Thickness ◽  
Enzyme Linked Immunosorbent Assay ◽  
Matricellular Protein ◽  
Laboratory Assessment ◽  
Cross Sectional ◽  
Rheumatoid Arthritis Disease

Background:Matricellular protein Cysteine-rich protein 61 (Cyr61) is involved in chronic inflammatory disorders like rheumatoid arthritis (RA) and atherosclerosis.Objectives:This study aimed to assess the value of serum Cyr61 in diagnosis of rheumatoid arthritis, evaluating its correlation with disease activity and its relation to atherosclerosis.Methods:Cross-sectional study included 105 RA patients classified into active and inactive groups according to disease activity score (DAS28) with 50 healthy age and gender-matched controls. Full clinical and laboratory assessment was done including enzyme-linked immunosorbent assay (ELISA) measurement of Cyr61. Bilateral assessment of carotid intima-media thickness (CIMT) was done using high resolution-ultrasonography. Comparison of Cyr61 between RA patients and controls, correlation between Cyr61 and disease activity and CIMT were analyzed with appropriate statistical analyses.Results:Significant elevation of Cyr61 in RA patients compared to controls (235.62±62.5 vs. 73.11±18.2) respectively. The cut off value of Cyr61 was 99.25 pg/ml, with area under the curve (AUC) =0.995, P <0.001, 98 % sensitivity and 95% specificity. Cyr61 was inversely correlated with DAS28 and its components in RA patients (r=- 0.92, r=- 0.94) (p<0.001). There was a significant positive correlation between Cyr61 levels and CIMT in inactive and active RA patients (r=0.88, r=0.47) respectively.Conclusion:Serum Cyr61 as a potential diagnostic biomarker in RA is inversely correlated with disease activity. High Cyr61 in RA is a risk factor for atherosclerosis. Disruption of serum Cyr61 is engaged in the pathogenesis of both rheumatoid arthritis and atherosclerosis which is a clue for a future treatment strategy of RA.References:[1]Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, Kavanaugh A, McInnes IB, Solomon DH, Strand V, Yamamoto K (2018) Rheumatoid arthritis. Nature reviews Disease primers 4:18001. doi:10.1038/nrdp.2018.1[2]Pelechas E, Kaltsonoudis E, Voulgari PV, Drosos AA (2019) Rheumatoid Arthritis. In: Pelechas E, Kaltsonoudis E, Voulgari PV, Drosos AA (eds) Illustrated Handbook of Rheumatic and Musculo-Skeletal Diseases. Springer International Publishing, Cham, pp 45-76. doi:10.1007/978-3-030-03664-5_3[3]Sparks JA (2019) Rheumatoid Arthritis. Annals of Internal Medicine 170 (1):ITC1-ITC16. doi:10.7326/aitc201901010[4]Abd El-Monem S, Ali A, Hashaad N, Bendary A, Abd El-Aziz H (2019) Association of rheumatoid arthritis disease activity, severity with electrocardiographic findings, and carotid artery atherosclerosis. Egyptian Rheumatology and Rehabilitation 46 (1):11-20. doi:10.4103/err.err_36_18[5]Rawla P (2019) Cardiac and vascular complications in rheumatoid arthritis. Reumatologia 57 (1):27-36. doi:10.5114/reum.2019.83236[6]de Brito Rocha S, Baldo DC, Andrade LEC (2019) Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis. Advances in Rheumatology 59 (1):2. doi:10.1186/s42358-018-0042-8Disclosure of Interests:None declared

scholarly journals A Posteriori Dietary Patterns and Rheumatoid Arthritis Disease Activity: A Beneficial Role of Vegetable and Animal Unsaturated Fatty Acids

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3856
Author(s):  
Valeria Edefonti ◽  
Maria Parpinel ◽  
Monica Ferraroni ◽  
Patrizia Boracchi ◽  
Tommaso Schioppo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Fatty Acids ◽  
Disease Activity ◽  
Dietary Patterns ◽  
Unsaturated Fatty Acids ◽  
Activity Index ◽  
Principal Component Factor Analysis ◽  
A Posteriori ◽  
Cross Sectional ◽  
Rheumatoid Arthritis Disease

To our knowledge, no studies have investigated the relationship between a posteriori dietary patterns (DPs)—representing current dietary behavior—and disease activity in patients with rheumatoid arthritis (RA). We analyzed data from a recent Italian cross-sectional study including 365 RA patients (median age: 58.46 years, 78.63% females). Prevalent DPs were identified through principal component factor analysis on 33 nutrients. RA activity was measured according to the Disease Activity Score on 28 joints (DAS28) and the Simplified Disease Activity Index (SDAI). Single DPs were related to disease activity through linear and logistic regression models, adjusted for the remaining DPs and confounders. We identified five DPs (~80% variance explained). Among them, Vegetable unsaturated fatty acids (VUFA) and Animal unsaturated fatty acids (AUFA) DPs were inversely related to DAS28 in the overall analysis, and in the more severe or long-standing RA subgroups; the highest score reductions (VUFA: 0.81, AUFA: 0.71) were reached for the long-standing RA. The SDAI was inversely related with these DPs in subgroups only. This Italian study shows that scoring high on DPs based on unsaturated fats from either source provides independent beneficial effects of clinical relevance on RA disease activity, thus strengthening evidence on the topic.

scholarly journals Serum Level of Endothelial Cell-Specific Molecule -1 (ESM -1) as a New Potential Biomarker for Rheumatoid Arthritis Disease Activity

2018 ◽  
Vol 12 (1) ◽  
pp. 189-196
Author(s):  
Noha Abdelsalam ◽  
Ashraf Hussein Mohamed ◽  
Sameh Abdellatif ◽  
Eslam Eid ◽  
Ehsan Mohamed Rizk ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Endothelial Cell ◽  
Disease Activity ◽  
Severe Disease ◽  
Serum Levels ◽  
Control Group ◽  
Cross Sectional ◽  
Das 28 ◽  
Rheumatoid Arthritis Disease ◽  
Potential Biomarker

Background:Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by destruction of the joint cartilage and bone. Endothelial dysfunction (ED) in RA may be related to disease activity. Our objective is to explore serum levels of endothelial cell-specific molecule-1 (ESM-1) as a biomarker for RA disease activity.Methods:A cross-sectional study was carried out and included 83 adult patients with RA, in addition to 20 healthy subjects (age and sex-matched) as a control group. Based on Disease Activity Score in 28 joints (DAS-28), the patient's group was subdivided into four subgroups(remission, mild, moderate and severe disease activity state). The demographic & clinical data, BMI, DAS-28 and Serological assessment [Erythrocyte Sedimentation Rate (ESR), CRP, Rheumatoid Factor (RF) and Anti-Citrullinated Peptide Antibody (ACPA)] were recorded. ESM-1was assayed for all participants.Results:Serum levels of ESM1 were significantly higher in the patient group than the control group (P< 0.0001). ESM-1 serum levels were significantly higher in patients with severe disease activity subgroup compared with patients with remission and mild disease activity subgroups (P< 0.0001). ESM-1 was positively and significantly correlated with DAS-28 score, The Health Assessment Questionnaire Disability Index (HAQ-DI) and modified Larsen score (P= 0.002, 0.0001 & 0.0001 respectively).Conclusion:ESM-1 could be a biomarker for RA disease activity.

scholarly journals Anemia e índices de atividade de doença em mulheres com artrite reumatoide

2018 ◽  
Vol 28 (2) ◽  
pp. 28816
Author(s):  
Thamiris Becker Scheffel ◽  
Aline Defaveri do Prado ◽  
Henrique Luiz Staub ◽  
Inês Guimarães da Silveira ◽  
Ana Lígia Bender
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Health Assessment ◽  
Disease Activity Index ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Artrite Reumatoide ◽  
Student’S T

AIMS: To evaluate disease activity indexes in female patients with rheumatoid arthritis, Anemic and Non-anemic, correlating with hemoglobin levels.METHODS: A cross-sectional study involved women with rheumatoid arthritis classified into two groups: 1) Anemic (hemoglobin <12 g/dL) and 2) Non-anemic. Disease activity was measured by Disease Activity Index (DAS28), using different inflammatory markers:  Erythrocyte Sedimentation Rate (ESR) and C-reative Protein (CRP).  This score also uses the number of swollen and painful joints and an overall assessment of the disease on Visual Analogue Scale (VAS). An assessment of functional capacity by the Health Assessment Questionnaire (HAQ) was also performed. The statistic used Student’s t-Test, Mann-Whitney, Wilcoxon, Fisher, likelihood ratio and Spearman correlation tests. It was considered significant p <0,05.RESULTS: Twenty-four patients were included, eight of Anemic group and 16 of Non-anemic. The groups were similar in terms of clinical, demographic and treatment characteristics, differing only in relation to rheumatoid factor, positive in all anemic participants and in 56,2% of non anemic participants. DAS28 ESR (median 6,05; interquartile range [IQR] 5,21-7,76), DAS28 CRP (median 4,32; IQR 3,98-5,92) and VAS (median 66,50 mm; IQR 54,75-80,50) were significantly higher in Anemic group. DAS28 ESR (-0,418) and VAS (-0,426) showed a significant negative correlation with hemoglobin level. DAS28 ESR and DAS28 CRP values were different in the same group, showing a discrepancy in the categorization of disease activity. In Anemic group, DAS28 ESR value (median 6,05; IQR 5,21-7,76) was higher in relation to DAS28 CRP (median 4,32; IQR 3,98-5,92). A less discrepant increase of DAS28 ESR (median 4,01; IQR 3,05-5,68) compared to DAS28 CRP (median 3,06; IQR 2,18-4,66) was observed in Non-anemic group.CONCLUSIONS: Anemia was associated with worse disease activity indexes in women with rheumatoid arthritis, correlated with greater pain intensity and increase of DAS28 ESR score.

scholarly journals Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Miyabi Uda ◽  
Motomu Hashimoto ◽  
Ryuji Uozumi ◽  
Mie Torii ◽  
Takao Fujii ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Multivariable Logistic Regression Analysis ◽  
Depression Symptoms ◽  
Cross Sectional ◽  
Multivariable Logistic Regression

Abstract Background The management of anxiety and depression symptoms in rheumatoid arthritis (RA) patients is vital. Previous study findings on this topic are conflicting, and the topic remains to be thoroughly investigated. This study aimed to clarify the association of RA disease activity with anxiety and depression symptoms after controlling for physical disability, pain, and medication. Methods We conducted a cross-sectional study of RA patients from the XXX Rheumatoid Arthritis Management Alliance cohort. We assessed patients using the Disease Activity Score (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), and Hospital Anxiety and Depression Scale (HADS). Anxiety and depression symptoms were defined by a HADS score ≥ 8. We analyzed the data using multivariable logistic regression analyses. Results Of 517 participants, 17.6% had anxiety symptoms and 27.7% had depression symptoms. The multivariable logistic regression analysis demonstrated that DAS28 was not independently associated with anxiety symptoms (odds ratio [OR] [95% confidence interval; CI] 0.93 [0.48–1.78]; p = 0.82) and depression symptoms (OR [95% CI] 1.45 [0.81–2.61]; p = 0.22). However, DAS28 patient global assessment (PtGA) severity was associated with anxiety symptoms (OR [95% CI] 1.15 [1.02–1.29]; p = 0.03) and depression symptoms (OR [95% CI] 1.21 [1.09–1.35]; p < 0.01). Additionally, HAQ-DI scores ≤ 0.5 were associated with anxiety symptoms (OR [95% CI] 3.51 [1.85–6.64]; p < 0.01) and depression symptoms (OR [95% CI] 2.65 [1.56–4.50]; p < 0.01). Patients using steroids were more likely to have depression than those not using steroids (OR [95% CI] 1.66 [1.03–2.67]; p = 0.04). Conclusions No association was found between RA disease activity and anxiety and depression symptoms in the multivariable logistic regression analysis. Patients with high PtGA scores or HAQ-DI scores ≤ 0.5 were more likely to experience anxiety and depression symptoms, irrespective of disease activity remission status. Rather than focusing solely on controlling disease activity, treatment should focus on improving or preserving physical function and the patient’s overall sense of well-being.

scholarly journals Cardiovascular risk factors are negatively associated with rheumatoid arthritis disease outcomes

2021 ◽  
Vol 13 ◽  
pp. 1759720X2098121
Author(s):  
Kangping Cui ◽  
Mohammad Movahedi ◽  
Claire Bombardier ◽  
Bindee Kuriya
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Rheumatoid Arthritis Disease

Aims: Rheumatoid arthritis (RA) is associated with cardiovascular disease (CVD), but the influence of CVD risk factors on RA outcomes is limited. We examined if CVD risk factors alone are associated with RA disease activity and disability. Methods: We performed a cross-sectional analysis of participants in the Ontario Best Practices Research Initiative, RA registry. Patients were categorized into mutually exclusive CVD categories: (1) No established CVD and no CVD risk factors; (2) CVD risk factors only including ⩾1 of hypertension, dyslipidemia, diabetes, or smoking; or (3) history of established CVD event. Multivariable regression analyses examined the effect of CVD status on Disease Activity Score 28 (DAS28-ESR), Clinical Disease Activity Index (CDAI), and Health Assessment Questionnaire Disability Index (HAQ-DI) scores at baseline. Results: Of 2033 patients, 50% had at least 1 CVD risk factor, even in the absence of established CVD. The presence of ⩾1 CVD risk factor was independently associated with higher CDAI [β coefficient 1.59, 95% confidence interval (CI) 0.29–2.90, p = 0.02], DAS28-ESR (β coefficient 0.20, 95% CI 0.06–0.34, p = 0.01) and HAQ-DI scores (β coefficient 0.15, 95% CI 0.08–0.22, p < 0.0001). The total number of CVD risk factors displayed a dose response, as >1 CVD risk factor was associated with higher disease activity and disability, compared with having one or no CVD risk factors. Conclusion: CVD risk factors alone, or in combination, are associated with higher disease activity and disability in RA. This emphasizes the importance of risk factor recognition and management, not only to prevent CVD, but also to improve potential RA outcomes.

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