目的 探讨膳食炎症指数(dietary inflammation index,DII)评分与类风湿关节炎(rheumatoid arthritis,RA)疾病活动度的关系.方法 采用食物频率问卷表(food frequency questionnaire,FFQ),调查RA患者(129 例)及健康对照者(131 例)3 月内的饮食摄入情况,计算DII,使用 28 处关节疾病活动性评估-红细胞沉降率(DAS28-ESR)评估RA患者的疾病活动度.将病情稳定的 118 例RA患者随机分为两组,一组行地中海饮食干预 4 月,另一组常规饮食,计算DII和DAS28-ESR.结果 RA患者的DII评分高于健康对照组(P=0.011).在RA患者中,DII评分与疾病活动度无显著相关性(P>0.05);DII评分的抗炎变化与维持 2 年内的低疾病活动性相关(OR=7.17,95%CI:2.53~20.28,P<0.001).干预 4 个月后,地中海饮食组DII评分和DAS28-ESR评分较前均降低,DAS28-ESR评分较常规饮食组亦有降低,差异均有统计学意义(P<0.05).结论 RA患者饮食的促炎作用高于健康者,DII评分的抗炎变化与RA患者维持低疾病活动度相关.地中海饮食有可能改善RA患者疾病活动度.
Objective To analyze the association between change in dietary inflammation index(DII)and rheumatoid arthritis(RA)disease activity.Methods The dietary intake of patients with RA(129 in total)and healthy controls(131 in total)over a period of three months was examined with the use of the food frequency questionnaire(FFQ)to calculate the DII.Additionally,the disease activity of patients with RA was assessed through the disease activity assessment at 28 joints-erythrocyte sedimentation rate(DAS28-ESR).One hundred and eighteen patients diagnosed with rheumatoid arthritis and exhibiting stable disease were randomly allocated into two groups,one receiving a Mediterranean dietary intervention for a duration of 4 months and the other following a conventional diet.DAS28-ESR and DII were determined.Results DII scores were significantly higher in patients with RA than in healthy controls(P=0.011).However,no significant correlation was observed between DII scores and disease activity in RA patients(P>0.05).Notably,anti-inflammatory changes in DII scores were associated with maintaining low disease activity over a period of two years(OR=7.17,95%CI 2.53-20.28,P<0.001).Following a four-month intervention,it was observed that the DII scores and DAS28-ESR scores of the Mediterranean diet group were lower than their initial values.The conventional diet group also experienced lower DAS28-ESR scores.Both differences were deemed to be statistically significant(P<0.05).Conclusions The inflammatory impact of diet was higher in RA patients compared to healthy individuals,and variations in DII scores indicative of anti-inflammatory changes were linked with sustained low disease activity in RA patients.The Mediterranean diet exhibits the potential to ameliorate disease activity in patients suffering from RA.