Session Information
Date: Monday, November 6, 2017
Title: Rheumatoid Arthritis – Human Etiology and Pathogenesis Poster II
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: The Mediterranean Diet has been associated with lower mortality and risk of cardiovascular diseases and cancer. Although its components have been analyzed in several studies, only two studies have investigated the association between Mediterranean diet and risk of rheumatoid arthritis (RA) and reported no association.
Methods: Data on 1726 incident cases and 3683 controls, matched on age, gender and residential area, from the Epidemiological Investigation of RA (EIRA), a population-based case-control study, was used to estimate the association between the Mediterranean dietary score and the risk of RA. The score, ranging from 0 to 9, was calculated using a 124-item food frequency questionnaire. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using conditional logistic regressions, and multivariable models were adjusted for body mass index, educational level, physical activity, use of dietary supplements, energy intake, and smoking.
Results: In the EIRA study (median age 53), 23.5% of the cases and 27.9% of the controls had a high adherence to the Mediterranean diet (a score between 6 and 9). An high adherence reduced the odds of developing RA by 23% (OR 0.76; 95% CI, 0.62-0.92) as compared to low adherence (a score between 0 and 2). The odds ratio was even lower among men (OR 0.49; 95% CI, 0.33-0.72), but no association was found among women (OR 0.89; 95% CI, 0.71-1.11). The inverse association was observed for rheumatoid factor (RF) positive (OR 0.66; 95% CI, 0.52-0.84), but not negative RA (OR 0.93; 95% CI, 0.66-1.30), and for antibodies to citrullinated peptides (ACPA) positive, but not ACPA-negative RA (Table 1).
Conclusion: In this large population-based case-control study, the Mediterranean diet score was inversely associated with risk of RA. The association was stronger among men than among women and no significant association was observed for seronegative RA.
Acknowledgments: This study was supported by grant from Forte (grant registration number 2015–00689).
Conflict of interest: The authors declare that they have not conflict of interest.
Table 1. Odds ratios of RA, overall and stratified by gender and ACPA, according to categories of the Mediterranean diet score
|
|
|
Mediterranean Diet Score |
|||
|
|
|
0-2 |
3 |
4-5 |
6-9 |
|
Overall |
|
|
|
|
|
|
|
N |
376/604 |
299/649 |
646/1403 |
405/1027 |
|
|
OR crude |
Ref |
0.76 (0.59-0.95) |
0.76 (0.65-0.90) |
0.64 (0.54-0.76) |
|
|
OR adjusted |
Ref |
0.80 (0.63-1.03) |
0.85 (0.72-1.01) |
0.76 (0.62-0.92) |
|
Female |
|
|
|
|
|
|
|
N |
251/438 |
218/450 |
473/1007 |
313/762 |
|
|
OR crude |
Ref |
0.85 (0.68-1.07) |
0.83 (0.69-1.01) |
0.73 (0.59-0.90) |
|
|
OR adjusted |
Ref |
0.91 (0.71-1.16) |
0.95 (0.77-1.16) |
0.89 (0.71-1.11) |
|
Male |
|
|
|
|
|
|
|
N |
125/166 |
81/199 |
173/396 |
92/265 |
|
|
OR crude |
Ref |
0.58 (0.41-0.83) |
0.63 (0.47-0.85) |
0.46 (0.33-0.65) |
|
|
OR adjusted |
Ref |
0.60 (0.41-0.88) |
0.65 (0.47-0.91) |
0.49 (0.33-0.72) |
|
ACPA positive |
|
|
|
|
|
|
|
N |
271/371 |
210/392 |
437/840 |
261/652 |
|
|
OR crude |
Ref |
0.74 (0.59-0.93) |
0.72 (0.59-0.87) |
0.56 (0.45-0.69) |
|
|
OR adjusted |
Ref |
0.80 (0.63-1.02) |
0.82 (0.67-1.01) |
0.69 (0.55-0.88) |
|
ACPA negative |
|
|
|
|
|
|
|
N |
103/173 |
88/188 |
205/400 |
144/273 |
|
|
OR crude |
Ref |
0.82 (0.58-1.18) |
0.91 (0.67-1.23) |
0.91 (0.66-1.26) |
|
|
OR adjusted |
Ref |
0.82 (0.56-1.20) |
0.93 (0.67-1.29) |
0.97 (0.68-1.29) |
Figure 1. Continuous association (with 95% confidence interval) of the Mediterranean diet score with RA, modeled using restricted cubic splines.
To cite this abstract in AMA style:
Di Giuseppe D, Johansson K, Askling J, Alfredsson L. Mediterranean Diet Is Inversely Associated with Risk of Rheumatoid Arthritis: A Swedish Population Based Case-Control Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/mediterranean-diet-is-inversely-associated-with-risk-of-rheumatoid-arthritis-a-swedish-population-based-case-control-study/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/mediterranean-diet-is-inversely-associated-with-risk-of-rheumatoid-arthritis-a-swedish-population-based-case-control-study/