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Rheumatology (Oxford). 2017 Dec 1;56(12):2229-2236. doi: 10.1093/rheumatology/kex360.

The association between omega-3 fatty acid biomarkers and inflammatory arthritis in an anti-citrullinated protein antibody positive population.

Author information

1
Department of Epidemiology, Colorado School of Public Health.
2
Division of Rheumatology, University of Colorado, Aurora.
3
Nine Health Services, Inc., Denver, CO.
4
Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA.

Abstract

Objectives:

Higher circulating omega-3 fatty acids (n-3 FAs) are associated with a lower prevalence of anti-CCP antibodies and RF in subjects without RA. We examined whether, in anti-CCP+ subjects, n-3 FAs also play a role in development of inflammatory arthritis (IA).

Methods:

At Colorado-based health fairs from 2008 to 2014, participants without a previous diagnosis of RA who were anti-CCP3+ (n = 47) were recruited into a follow-up study; symptom assessments and joint examinations were conducted every 6 months for the determination of IA. We measured n-3 FAs as a percentage of total lipids in red blood cell membranes (n-3 FA%) at each visit.

Results:

We detected IA in 10 anti-CCP3+ subjects (21%) at the baseline visit. Increased total n-3 FA% in red blood cell membranes [odds ratio (OR) = 0.09, 95% CI: 0.01, 0.76], specifically docosapentaenoic acid (OR = 0.16, 95% CI: 0.03, 0.83) and docosahexaenoic acid (OR = 0.23, 95% CI: 0.06, 0.86), was associated with a lower odds of IA at the baseline visit, adjusting for n-3 FA supplement use, current smoking, RF+, elevated CRP+ and shared epitope. We followed 35 of the anti-CCP3+ subjects who were IA negative at baseline and detected 14 incident IA cases over an average of 2.56 years of follow-up. In a time-varying survival analysis, increasing docosapentaenoic acid significantly decreased risk of incident IA (hazard ratio = 0.52, 95% CI: 0.27, 0.98), adjusting for age at baseline, n-3 FA supplement use, RF+, CRP+ and shared epitope.

Conclusion:

n-3 FAs may potentially lower the risk of transition from anti-CCP positivity to IA, an observation that warrants further investigation.

KEYWORDS:

autoantigens and autoantibodies; autoinflammatory conditions; diet therapy; epidemiology; rheumatoid arthritis

PMID:
29029330
PMCID:
PMC5850337
DOI:
10.1093/rheumatology/kex360
[Indexed for MEDLINE]
Free PMC Article

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