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Dietary Inflammatory Index Score and Cardiovascular Disease Risk Markers in Women with Systemic Lupus Erythematosus

Published:September 03, 2019DOI:https://doi.org/10.1016/j.jand.2019.06.007

      Abstract

      Background

      Patients with systemic lupus erythematosus (SLE), a chronic inflammatory autoimmune disease, have an increased risk of developing cardiovascular diseases. Environmental factors like diet and nutrition are known to play a key role in modulating inflammation and the prognosis of cardiovascular diseases.

      Objective

      To investigate the relationship between Dietary Inflammatory Index score and cardiovascular disease risk markers in a population of women with SLE.

      Design

      A cross-sectional study was conducted in women with SLE recruited from 2016 through 2017.

      Participants/settings

      Clinically stable women with SLE were enrolled from three public hospitals in the Andalusian region of Spain. Participants with chronic renal failure, active infections, recent trauma, pregnancy, and/or other autoimmune diseases were excluded.

      Main outcome measures

      A 24-hour diet recall was used to estimate Dietary Inflammatory Index score and physical activity was assessed through the International Physical Activity Questionnaires. Cardiovascular disease risk markers included blood lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels), high-sensitivity C-reactive protein levels, and homocysteine levels, along with diagnosis of obesity, diabetes mellitus, hypertension, dyslipidemia, and ankle-brachial index measurement.

      Statistical analysis

      Comparisons of cardiovascular disease risk markers across Dietary Inflammatory Index score tertiles were analyzed through a one-way analysis of variance and linear regressions adjusting for age, physical activity level, and medical treatment.

      Results

      A total of 105 women (aged 45.4±12.8 years) were included. Linear regression analysis revealed that Dietary Inflammatory Index score was significantly associated with total cholesterol levels (β=.26, 95% CI 1.66 to 14.28; P=0.014) after adjusting for age, physical activity, and the use of medical treatment. No significant associations were observed between Dietary Inflammatory Index score and the other cardiovascular markers considered.

      Conclusions

      Higher inflammatory potential of the diet was positively associated with higher total cholesterol levels in women with SLE. These findings suggest that the inflammatory potential of a person’s diet may play a role in lipid profiles in this population. Future intervention studies are needed to build on these results and explore the effect of anti-inflammatory diets on health outcomes in individuals with SLE.

      Keywords

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      Biography

      G. Pocovi-Gerardino is a predoctoral fellow, Public Health and Clinic Medicine PhD program, University of Granada, Granada, Spain, and the Biosanitary Research Institute, Granada, Spain.

      Biography

      M. Correa-Rodríguez is an associate professor, Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain, and the Biosanitary Research Institute, Granada, Spain.

      Biography

      J.-L. Callejas-Rubio is a medical doctor, Systemic Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain, and the Biosanitary Research Institute, Granada, Spain.

      Biography

      R. Ríos-Fernández is a medical doctor, Systemic Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain, and the Biosanitary Research Institute, Granada, Spain.

      Biography

      M. Martín-Amada is a medical doctor, Systemic Autoimmune Diseases Unit, Complejo Hospitalario de Jaén, Jaén, Spain.

      Biography

      M.-G. Cruz-Caparros is a medical doctor, Systemic Autoimmune Diseases Unit, Hospital de Poniente, El Ejido, Spain.

      Biography

      B. Rueda-Medina is a professor, Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain, and the Biosanitary Research Institute, Granada, Spain.

      Biography

      N. Ortego-Centeno is a professor, School of Medicine, University of Granada, Granada, Spain; and a medical doctor, Systemic Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain, and the Biosanitary Research Institute, Granada, Spain.