title: Diet and fatty acid pattern among patients with SLE: associations with disease activity, blood lipids and atherosclerosis.
abstract: OBJECTIVE
  As atherosclerosis is increased in systemic lupus erythematosus (SLE) we compared dietary habits in patients with SLE with controls, and in the patients studied associations of diet components, especially fatty acids (FAs), with disease activity, serum lipids and carotid plaque presence.
  
  
  METHODS
  In all 114 patients with SLE and 122 age- and sex-matched population-based controls answered a food frequency questionnaire (FFQ). Subcutaneous abdominal fat cell aspiration was analysed as to FA content and plaque occurrence was determined by B-mode ultrasound.
  
  
  RESULTS
  The total diet energy intake did not differ between patients and controls. However, the patients with SLE reported a higher intake of carbohydrate, lower fibre intake and lower intake of omega-3 and omega-6, than controls (p < 0.05). In the patients, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in adipose tissue (AT) correlated negatively with disease activity (SLEDAI), r = -0.36, p = < 0.001 and r = -0.33, p = < 0.001, respectively. AT omega-3 was further positively associated with serum apoA1, r = 0.29, p = 0.004, whereas AT omega-6 showed a negative association, r = -0.21, p = 0.040. These FAs also had opposite associations with plaque presence, EPA and were DHA negative, r = -0.32, p = 0.002 and r = -0.33, p = 0.001, respectively, and omega-6 positive, r = 0.22, p = 0.027. The carbohydrate intake was positively correlated to AT omega-6, r = 0.38, p < 0.001, and negatively with serum apoA1, r = -0.27, p = 0.005.
  
  
  CONCLUSIONS
  The macronutrient dietary pattern is different in SLE as compared with controls. The low intake of omega-3 and high intake of carbohydrate among patients with SLE appear to be associated with worse disease activity, adverse serum lipids and plaque presence.
authors.affiliation: Department of Rheumatology, Karolinska Institutet at Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. ann-charlotte.elkan@ki.se
authors.forename: A-C
authors.initials: AC
authors.lastname: Elkan
authors.forename: C
authors.initials: C
authors.lastname: Anania
authors.forename: T
authors.initials: T
authors.lastname: Gustafsson
authors.forename: T
authors.initials: T
authors.lastname: Jogestrand
authors.forename: I
authors.initials: I
authors.lastname: Hafström
authors.forename: J
authors.initials: J
authors.lastname: Frostegård
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D016632:Apolipoprotein A-I / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000097:blood* / Q000175:diagnosis; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000378:metabolism; D004041:Dietary Fats / Q000097:blood*; D004043:Dietary Fiber / Q000378:metabolism; D002149:Energy Intake; D005227:Fatty Acids / Q000097:blood*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D018616:Ultrasonography, Doppler, Duplex
chemical_list: C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D005227:Fatty Acids