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Abstract Number: 1348

Swollen Joint Count, but Not Inflammatory Cytokines, Differs By Frequency of Fish Consumption in a Cross-Sectional Rheumatoid Arthritis Cohort

Sara K. Tedeschi1, Joan Bathon2, Jon T. Giles3, Tzu-Chieh Lin4, Kazuki Yoshida5 and Daniel Solomon1, 1Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, 2Division of Rheumatology, Columbia University, College of Physicians & Surgeons, New York, NY, 3Division of Rheumatology, Columbia University College of Physicians & Surgeons, New York, NY, 4Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 5Brigham and Women's Hospital, Boston, MA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: cytokines and rheumatoid arthritis (RA), Disease Activity

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Session Information

Date: Monday, November 6, 2017

Session Title: Rheumatoid Arthritis – Clinical Aspects Poster II: Pathophysiology, Autoantibodies, and Disease Activity Measures

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Omega-3 fatty acids downregulate pro-inflammatory cytokines, thus have been of interest as adjunctive rheumatoid arthritis (RA) therapy for decades. We previously reported an inverse association between disease activity measured by DAS28-CRP and frequency of fish consumption in an RA cohort.1 The present study tested whether individual components of DAS28-CRP or other inflammatory cytokines were related to frequency of fish intake.

Methods:  We conducted a cross-sectional analysis using baseline data from participants in a prospective cohort study of cardiovascular disease in RA. Frequency of fish consumption was assessed by a baseline food frequency questionnaire assessing usual diet in the past year. DAS28-CRP was calculated using tender joint count (TJC), swollen joint count (SJC), and C-reactive protein (CRP) measured at baseline. Multivariable, total energy-adjusted linear regression models provided effect estimates and 95% confidence intervals (CI) for frequency of non-fried fish consumption (never to <1/month, 1/month to <1/week, 1/week, and ≥2/week) on baseline TJC, SJC, and natural log (ln)-transformed cytokine levels. We also estimated the difference in each outcome associated with increasing fish consumption by one serving per week. A sensitivity analysis additionally adjusted for pack-years.

Results:  Among 176 participants, 60% were female and median age was 59 years (interquartile range [IQR] 53-65). Seventy-nine percent were seropositive (RF or anti-CCP), median disease duration was 9 years (IQR 5-17), and median DAS28-CRP was 3.5 (IQR 2.9-4.3). Current medications taken as mono- or combination therapy included non-biologic disease modifying anti-rheumatic drugs (DMARDs) in 87%, biologic DMARDs in 46%, glucocorticoids in 39%, and fish oil supplements in 9%. Twenty percent ate fish never to <1/month and 18% ate fish ≥2 times/week. In adjusted linear regression models, subjects consuming fish ≥2 times/week had a significantly lower SJC compared with subjects who ate fish never to <1/month (difference -3.51 [95% CI -5.87, -1.16]) (Table). For each additional serving of fish per week, SJC was significantly reduced by 1.18 (95% CI -2.03, -0.33). We did not observe differences in TJC or ln-transformed cytokine levels based on frequency of fish consumption. Further adjustment for smoking produced similar results.

Conclusion: Differences in SJC according to frequency of fish consumption may explain our previous observation that higher intake of fish was associated with lower disease activity as measured by DAS28-CRP in RA patients.

1. Tedeschi SK, Bathon JM, Giles JT, Lin T-C, Yoshida K, Solomon DH. The relationship between fish consumption and disease activity in rheumatoid arthritis. Arthritis Care Res. 2017 [in press]

 

Table. Differences in swollen joint count, tender joint count, and natural log-transformed cytokines by frequency of fish consumption

Frequency of fish consumption

 

Outcome

Never to <1/month

n=35

1/month to <1/week

n=72

1/week

n=38

≥2/week

n=31

Difference in outcome per

1 additional serving of fish/week

Adjusted β-coefficient* (95% CI)

Adjusted β-coefficient*+ (95% CI)

SJC

0 (ref)

-1.99 (-3.91, -0.06)

-2.80 (-5.02, -0.57)

-3.51 (-5.87, -1.16)

-1.18 (-2.03, -0.33)

TJC

0 (ref)

-0.22 (-3.83, 3.39)

-0.81 (-4.99, 3.36)

-2.09 (-6.51, 2.32)

-0.84 (-2.42, 0.74)

CRP#

0 (ref)

-0.40 (-0.95, 0.14)

-0.45 (-1.09, 0.18)

-0.55 (-1.22, 0.11)

-0.17 (-0.41, 0.07)

IL-6#

0 (ref)

-0.29 (-0.67, 0.09)

-0.09 (-0.53, 0.35)

-0.38 (-0.84, 0.09)

-0.10 (-0.27, 0.07)

ICAM#

0 (ref)

-0.13 (-0.29, 0.02)

-0.04 (-0.22, 0.14)

-0.09 (-0.28, 0.10)

-0.01 (-0.08, 0.06)

fibrinogen#

0 (ref)

-0.07 (-0.19, 0.05)

-0.003 (-0.14, 0.13)

-0.10 (-0.24, 0.04)

-0.03 (-0.08, 0.02)

e-selectin#

0 (ref)

-0.29 (-0.57, -0.01)

-0.35 (-0.68, -0.04)

-0.26 (-0.59, 0.08)

-0.07 (-0.19, 0.06)

Abbreviations: CI: confidence interval  SJC: swollen joint count  TJC: tender joint count  CRP: C-reactive protein   IL-6: interleukin 6   ICAM: intercellular adhesion molecule

* β-coefficient (95% CI) from linear regression models adjusted for total energy intake, age in decades, sex, body mass index in kg/m2 (<25, 25 to <30, ≥30), CES-Depression score (continuous), married (yes/no), biologic DMARD use (yes/no), fish oil supplement use (yes/no)

+ β-coefficient (95% CI) from a term representing the median frequency of fish consumption per week in each exposure group, which represents the difference in outcome per 1 additional serving of fish/week

#All cytokines are natural log-transformed

 


Disclosure: S. K. Tedeschi, None; J. Bathon, None; J. T. Giles, None; T. C. Lin, None; K. Yoshida, None; D. Solomon, None.

To cite this abstract in AMA style:

Tedeschi SK, Bathon J, Giles JT, Lin TC, Yoshida K, Solomon D. Swollen Joint Count, but Not Inflammatory Cytokines, Differs By Frequency of Fish Consumption in a Cross-Sectional Rheumatoid Arthritis Cohort [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/swollen-joint-count-but-not-inflammatory-cytokines-differs-by-frequency-of-fish-consumption-in-a-cross-sectional-rheumatoid-arthritis-cohort/. Accessed January 27, 2023.
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