背景:系统性红斑狼疮(SLE)是一种复杂的自身免疫性疾病,会影响多个器官系统,在育龄妇女中患病率较高。该疾病的多因素病因涉及遗传,环境,和荷尔蒙成分。最近的研究强调了饮食因素的潜在影响,特别是不饱和脂肪酸,关于SLE的调节,由于它们的抗炎特性。这项荟萃分析旨在评估不饱和脂肪酸消耗与风险之间的关系,programming,和SLE的临床表现,为饮食管理提供循证指导。
方法:截至2024年1月,我们对主要医学数据库进行了全面搜索,重点是研究不饱和脂肪酸的摄入量以及这种摄入量对SLE的影响。使用PICOS(人口,干预,比较器,结果,研究设计)框架,我们纳入了随机对照试验和病例对照研究,评估结果,如SLE活动,通过SLE疾病活动指数(SLEDAI)或不列颠群岛狼疮评估组(BILAG)指数测量,炎症生物标志物。研究使用基于异质性的固定效应或随机效应模型(I2统计量)进行分析,进行敏感性分析以评估结果的稳健性。
结果:我们的搜索包括10项研究,涵盖各种各样的设计和人群。荟萃分析显示,富含不饱和脂肪酸的饮食与SLEDAI评分(合并SMD)-0.36,95%CI:-0.61至-0.11,p=0.007显着相关,表明对疾病活动的有益作用。此外,我们发现不饱和脂肪酸的摄入对HDL水平有显著影响,提示对血脂有积极影响。然而,对炎症标志物IL-6或其他脂质成分(LDL和胆固醇)的水平没有观察到显著影响.研究之间的异质性最小(I2≤15%),灵敏度分析证实了这些结果的稳定性和可靠性,强调不饱和脂肪酸在SLE管理中的潜在作用。
结论:这项荟萃分析表明,饮食摄入不饱和脂肪酸可能在降低SLE活性方面发挥积极作用,并且可能显著影响HDL水平,而对炎症标志物或其他血脂谱没有显著影响。这些发现支持将不饱和脂肪酸纳入SLE患者的饮食管理,尽管需要进一步的研究来完善饮食建议并探索这些关联的潜在机制.
BACKGROUND: Systemic lupus erythematosus (
SLE) is a complex autoimmune disorder that affects multiple organ systems, with a higher prevalence among women in their reproductive years. The disease\'s multifactorial etiology involves genetic, environmental, and hormonal components. Recent studies have highlighted the potential impact of dietary factors, particularly unsaturated fatty acids, on the modulation of
SLE due to their anti-inflammatory properties. This meta-analysis aims to evaluate the association between unsaturated fatty acid consumption and the risk, progression, and clinical manifestations of
SLE, providing evidence-based guidance for dietary management.
METHODS: We conducted a comprehensive search across major medical databases up to January 2024, focusing on studies that examined the intake of unsaturated fatty acids and the impact of such intake on
SLE. Using the PICOS (population, intervention, comparator, outcomes, study design) framework, we included randomized controlled trials and case-control studies, assessing outcomes such as SLE activity, measured by
SLE Disease Activity Index (SLEDAI) or the British Isles Lupus Assessment Group (BILAG) index, inflammation biomarkers. Studies were analyzed using either a fixed- or random-effects model based on heterogeneity (I2 statistic), with sensitivity analyses performed to assess the robustness of the findings.
RESULTS: Our search included 10 studies, encompassing a wide variety of designs and populations. The meta-analysis showed that a diet rich in unsaturated fatty acids is significantly associated with a reduction in SLEDAI scores (pooled SMD) of -0.36, 95% CI: -0.61 to -0.11, p = 0.007, indicating a beneficial effect on disease activity. Additionally, we found that unsaturated fatty acid intake has a significant impact on HDL levels, suggesting a positive effect on lipid profiles. However, no significant effects were observed on levels of the inflammatory marker IL-6 or other lipid components (LDL and cholesterol). With minimal heterogeneity among studies (I2 ≤ 15%), sensitivity analysis confirmed the stability and reliability of these results, highlighting the potential role of unsaturated fatty acids in SLE management.
CONCLUSIONS: This meta-analysis suggests that dietary intake of unsaturated fatty acids may play a positive role in reducing SLE activity and may significantly affect HDL levels without having significant effects on inflammation markers or other lipid profiles. These findings support the inclusion of unsaturated fatty acids in the dietary management of SLE patients, although further research is required to refine dietary recommendations and explore the mechanisms underlying these associations.