[ Association between anthropometric indices and disease severity in women with Rheumatoid Arthritis]

Background and Objectives: Rheumatoid arthritis [RA] is an autoimmune disease that inflammatory mediators has an important role in its pathogenesis and leads to bone and joints destruction. This inflammatory status can be effected by different factors such as genetic, dietary intakes and hormonal factors. However, the influence of anthropometric on the severity of RA and inflammatory markers is still debatable

Material and Methods: The current study was done on a group of patients with documented RA who were under regular visit in our university hospital outpatients clinic from the start until the end of 2012. Based on DAS-28 criteria disease activity was assessed by a rheumatology specialist. Anthropometric measurements included body mass index [BMI], Waist to hip ratio [WHR],Waist to Height Ratio [WHtR] all were measured serum levels of highly sensetive cpp IL-6 and MMP-3, were measured in fasting serum samples

Results: There was a Positive correlation between obesity [body mass index and waist to height ratio] and disease activity score and serum levels of hsCRP [P <0.05]. There was no significant correlation between obesity with serum levels of MMP-3 and IL-6 [P > 0.05]

Conclusion: Present study indicates a significant direct correlation between obesity and disease activity and systemic inflammation marker [hscRP]. In RA thus, control of weight could be a very important strategy for maintenance remission in rheumatoid arthritis

Effects of phylloquinone supplementation on lipid profile in women with rheumatoid arthritis: a double blind placebo controlled study

BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin K1 as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin K1 in lipid profile modification remains still controversial. This study showed that vitamin K1 has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.

Effects of phylloquinone supplementation on lipid profile in women with rheumatoid arthritis: a double blind placebo controlled study

BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin K1 as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin K1 in lipid profile modification remains still controversial. This study showed that vitamin K1 has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.

Effect of Alpha-lipoic Acid Supplementation on Serum Lipid Profile in Women with Rheumatoid Arthritis

Alpha-lipoic acid [ALA] is considered as a potent antioxidant with anti-inflammatory functions. Moreover, a number of studies have revealed its lipid lowering properties. Therefore, we aimed to examine the effect of ALA on serum lipids in women with rheumatoid arthritis [RA], who have high mortality rate mainly due to accelerated atherosclerosis. In the present study a total of 70 RA patients were randomly assigned into two groups [1:1] to receive either ALA [1200 mg/day] or placebo for 8 weeks. Fasting blood samples were obtained before and after the intervention to analyze serum lipid profile including triglycerides [TG], total cholesterol [TC], high density lipoprotein cholesterol [HDL-C], and low density lipoprotein cholesterol [LDL-C]. International physical activity questionnaire [IPAQ] was assessed at baseline and final. Between-group comparisons were done using Student's t-test and ANCOVA at baseline and after 8 weeks, respectively. Paired t-test was used for within-group comparisons. Sign test and Mann-Whitney's test were used for intra- and inter-group comparisons of qualitative variables, respectively. P<0.05 was considered as significant. Finally, 65 RA patients completed the trial. No statistically significant differences were observed in serum lipid levels within and between the groups before and after the study. There were no significant intra- and inter-group differences in physical activity levels at the beginning and in the end of the study. In the present study, serum lipid profile was not significantly affected by ALA intervention. However, ALA supplementation aiming at prevention or treatment of dyslipidemia in RA patients should be further investigated

Beneficial role of antioxidants on clinical outcomes and erythrocyte antioxidant parameters in rheumatoid arthritis patients

Background: This study aims to investigate the effect of antioxidants supplement on clinical outcomes and antioxidant parameters in rheumatoid arthritis [RA]

Methods: The pre post study was conducted on 40 female patients with RA in 12 weeks that taken daily one "Selenplus" capsule contained 50 microg selenium, 8 mg zinc, 400 microg vitamin A, 125 mg vitamin C, and 40 mg vitamin E. About 5 mL venous blood sample was taken from all participants and disease activity score [DAS] was determined by DAS 28 formula and high sensitive C-reactive protein [hs-CRP]. Glutathione peroxidase [GPX] and superoxide dismutase [SOD] were measured by spectrophotometric kit and catalase [CAT] was measured by Abei method. Total antioxidant capacity [TAC] was determined by spectrophotometric kit. Distribution of the variables was assessed using histogram with normal curve as well as Kolmogorov-Smirnov test and data were analyzed with paired t-test for differences between pre-post data using SPSS software version 13.5

Results: Out of 40 patients, 39 completed the study. DAS-28 score and hs-CRP have changed [P < 0.01 for both], while the number of swollen and painful joints did not reduce significantly. TAC, GPX, SOD, and CAT increased significantly [P < 0.01 for all variables]

Conclusions: Our findings showed that antioxidants may improve disease activity significantly, but it did not affect the number of painful and swollen joints and increased erythrocyte antioxidant levels. Antioxidants may be useful for controlling of clinical outcomes and oxidative stress in RA

Effect of fish oil supplements on serum paraoxonase activity in female patients with rheumatoid arthritis: a double-blind randomized controlled trial

This study was conducted to determine the effect of fish oil [FO] supplements on high density lipoprotein cholesterol [HDL-C], apolipoprotein-Al [Apo-Al], malondialdehyde [MDA], arylesterase [Aryl], and paraoxonase-1 [PON1] activity in female patients with rheumatoid arthritis [RA]. A total of 90 RA patients were randomly allocated into two groups that were treated with one FO pearl [1 gr] daily or placebo for three months in addition to conventional treatment. HDL-C, Apo-Al, and MDA levels as well as POW and Aryl activities were measured before and after treatment. Independent t-test was used to match basal parameters of case and control groups. Paired t-test was used to assess significance of the differences. Correlation was evaluated by Pearson's test and the statistical significance was set at P < 0.05. No significant differences were noted between FO and placebo patients with regards to age, disease duration, post-menopausal status, conventional therapy, body mass index [BMI], and numbers of swollen and tender joints at the beginning of the study. There were 83 patients who completed the three-month follow up. Serum levels of HDL-C [P = 0.018], Apo-Al [P = 0.165], Aryl [P = 0.026], and POW [P = 0.049] activity increased, whereas MDA levels decreased significantly with FO supplementation [P= 0.077]. Significant correlations between increased POW activity and both HDL-C [P = 0.007, r = 0.419] and Apo-Al [P < 0.001, r = 0.742] concentrations as well as between HDL-C and Apo Al levels [P= 0.01, r = 0.403] were found. According to the results of this study, EQ could increase serum HDL-C and PQN1 levels and Aryl activity in female patients with RA

Dietary intake and serum bone related chemistry and their correlations in postmenopausal Iranian women

To determine dietary intake and bone related chemistry of osteoporosis and their correlations in postmenopausal Iranian women. A cross-sectional study was carried out on 58 healthy Iranian, postmenopausal women from January 2005 until August 2006, at Sina Hospital, Tabriz, Iran. Serum calcium, phosphorus, magnesium, and alkaline phosphatase were measured using auto analyzer and parathyroid hormone [PTH] by immune radio metric assay. Dietary intake was assessed by 3-day dietary record. Bone mineral density [BMD] was assessed by dual-energy x-ray absorptiometry [DXA] at the lumbar spine and left femur. Comparison between means of the groups was carried out using one-way analysis of variance test. To examine the correlation between dietary factors and bone related chemistry markers, multiple and linear regression was used. According to the results of lumbar spine BMD, women [n=58] were classified into 3 groups: normal [n=18], osteopenia [n=22], and osteoporosis [n=18]. The mean serum calcium, phosphorus, magnesium, and alkaline phosphatase in 3 groups were in the normal range. Serum PTH in the osteoporosis group was higher than other groups. The mean dietary calcium intake in the osteoporosis groups was significantly lower than the normal group [p=0.01]. The results of analyzing by linear regression, showed a significant correlation between calcium intake and PTH [r=-0.61, p=0.0001, B=-0.032]. These findings suggest that postmenopausal women need to be educated regarding osteoporosis and the related preventive measures, such as the effect of nutrients on bone health, and the adequate intake of dairy products and calcium rich-foods