Marine ω-3, vitamin D levels, disease outcome and periodontal status in rheumatoid arthritis outpatients

Nutrition. 2018 Nov:55-56:116-124. doi: 10.1016/j.nut.2018.03.054. Epub 2018 Apr 4.

Abstract

Objectives: Marine ω-3 fatty acids (FAs) and Vitamin D (VitD) are reportedly capable of down-regulating inflammation in rheumatoid arthritis (RA) and periodontal disease. This study was undertaken to relate marine FA and VitD status to RA disease status and periodontal conditions.

Methods: RA outpatients (age ≥35 y) were consecutively recruited. Rheumatologic clinical data were collected and periodontal status obtained. A food frequency questionnaire was used to estimate fish and supplement intake. FA profiles in whole-blood and serum VitD levels were determined.

Results: A total of 78 RA patients (age 57 ± 12 y, disease duration 15 ± 11 y) were included, 58% had active RA. Periodontitis was diagnosed in 82% of the patients, 18% had severe periodontitis. Seropositivity for rheumatoid factor and/or anticitrullinated protein antibodies was related to higher prevalence of periodontitis (P= 0.008). Seafood intake in accordance with nutritional recommendations was associated with better RA disease outcome (largest P= 0.008). An ω-3 index >8, present in 14% of the patients, correlated with a more desirable patient global health assessment scored on a visual analog scale (VAS; P= 0.004), lower periodontal probing depth (PD; P= 0.021), and ω-3 supplementation (P= 0.001). Serum VitD levels >50 nmol/L were found in 89%, of these 48% had VitD levels ≥75 nmol/L, no differences were found for RA disease activity and periodontal measurements.

Conclusions: Seropositive RA patients had a higher prevalence of periodontitis than seronegative patients. An ω-3 index >8 was related to ω-3 supplementation and more desirable VAS and lower PD. VitD status was satisfactory for most patients and was not associated with differences in RA severity or periodontal diagnosis.

Keywords: Periodontitis; Rheumatoid arthritis; S-25(OH)D; Seafood; ω-3 index.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / blood*
  • Arthritis, Rheumatoid / complications
  • Diet / adverse effects
  • Diet / statistics & numerical data
  • Diet Surveys
  • Dietary Supplements / analysis
  • Fatty Acids, Omega-3 / analysis
  • Fatty Acids, Omega-3 / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Outpatients
  • Periodontitis / epidemiology*
  • Periodontitis / etiology
  • Prevalence
  • Seafood / analysis*
  • Vitamin D / analysis
  • Vitamin D / blood*

Substances

  • Fatty Acids, Omega-3
  • Vitamin D