Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Autoimmune diseases (AD) are complex diseases associated with both genetic and environmental risk factors. In the last 10 years major advances have been made in the characterization of the genetic basis of AD. To date, very little is known on the environmental factors associated to AD.
The objective of the present study was to characterize the dietary patterns of six of the most prevalent ADs, and evaluate the effect of disease on the observed changes.
Methods: A total cross-sectional cohort of 11,621 individuals from Spain encompassing six prevalent ADs (RA n=1,949; psoriasis (PS) n=2,186; PsA n=1,437; SLE n=699, ulcerative colitis (UC) n=1,415; Crohn’s disease (CD) n=1,952) and healthy controls (n=1,983), was recruited through the IMID-Consortium from 2,007 to 2,012. Dietary habits were registered through a common epidemiological questionnaire, including biometric, socio-demographic and lifestyle information. For each individual, the weekly consumption frequency of 13 main food categories was recorded. Disease-specific main effects and moderation by disease activity were tested for statistical significance. Multivariate linear models were used to test for association with adjustment for main confounding covariates (e.g. age, gender, geographic region, BMI). In a subset of patients and controls with GWAS data (n=7,402) mendelian randomization (MR) was used to support the causality of disease on the observed diet variation.
Results: As expected, patients with ADs targeting the digestive system -UC and CD- showed the largest food consumption differences in comparison to healthy controls. This included a highly significant increase in bread, pasta and sweets (P< 1e-8 in CD, P< 1e-5 in UC). Like IBDs, SLE and PsA patients had a higher ingestion of sweets, and RA patients showed a higher consumption of bread (P< 0.05). Specifically, chronic arthritis RA and PsA had a reduced consumption of meat (P< 5e-4) compared to controls. RA and UC (but not CD) incorporated more fruit in their diet. Testing for association between disease activity in the three rheumatic diseases -SLEDAI for SLE and DAS28 for RA and PsA- did not support a direct association between the previous food groups with severity but revealed a positive association between dairy and disease activity in RA. Using a MR approach, we provide evidence that several of the observed dietary changes are caused by the disease. High smoking cessation rates were observed in UC, CD and SLE, but not in Ps, RA and PsA. Alcohol consumption was significantly lower in all ADs compared to healthy subjects. MR analysis showed that disease was the main cause for this change of habit in SLE (P< 5e-11) and RA (P< 5e-7), but not in PsA (P=0.21).
Conclusion: Using a large cross-sectional cohort of patients and controls from the Spanish population we provide, for the first time, a simultaneous analysis of the dietary habits of six autoimmune diseases. Our results confirm the high impact of IBD on diet alteration but also show multiple previously unreported associations with food categories and rheumatic ADs. Mendelian Randomization analyses support the causal effect of disease on multiple of the observed dietary changes but also suggest the presence of reverse causation.
To cite this abstract in AMA style:Julià A, Martinez S, Tornero J, Cañete J, Fernández-Nebro A, Blanco F, Rodríguez J, Lopez-Longo F, Fernandez-Gutierrez B, Gratacós J, Pérez Venegas J, Pérez C, Queiró R, Olivé-Marqués A, Alperi-López M, Montilla C, Andreu J, Torre-Alonso J, Aguirre-Zamorano M, Corominas H, Vela P, Martínez-Taboada V, Marique S, Nolla J, Gonzalez I, Muñoz-Fernandez S, Marenco de la Fuente J, González C, Zea A, Lopez Lasanta M, Roig D, Pego-Reigosa J, Lopez Corbeto M, Zarco P, Freire González M, Erra A, Díez E, Castañeda S, Rodriguez E, García A, Carreira P, Salvador G, Blanco R, Diaz-Torne C, Willisch Domínguez A, Mosquera J, Sánchez-Fernández S, Ramírez J, Marsal S. Cross-sectional Study and Mendelian Randomization Analysis of Diet in Six Prevalent Autoimmune Diseases [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/cross-sectional-study-and-mendelian-randomization-analysis-of-diet-in-six-prevalent-autoimmune-diseases/. Accessed December 5, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cross-sectional-study-and-mendelian-randomization-analysis-of-diet-in-six-prevalent-autoimmune-diseases/