Endocrine Abstracts

Introduction: There is solid epidemiologic evidence linking psoriasis and psoriatic arthritis (PsA) to cardiovascular risk factors and an increased risk for developing cardiovascular diseases. Despite this, dietetic advice is not routinely performed in clinical practice in patients with inflammatory arthropathies and the potential effect of diet on metabolic profile and inflammatory activity is few studied in these patients. This research aims to describe dietetic habits of a cohort of patients with PsA and to investigate the potential influence of these habits on metabolic profile, particularly on atherogenic dyslipidemia, and inflammatory activity.

Methods/design: In this cross-sectional study, forty out-patients with PsA were included. Qualitative and quantitative characteristics of food intake were recorded in all patients. According to characteristics of diet, patients were classified in three groups: High protein, balanced or high carbohydrate diet. Demographic data and metabolic profile were collected. Atherogenic index was calculated as marker of cardiovascular disease. Inflammatory activity was measured by erythrocyte sedimentation rate (ESR), reactive C protein (RPC) and disease activity score (DAS 28).

Results: Balanced, high carbohydrate and high protein diet were followed by 54%, 30% and 17% of the cohort respectively. Patients with high protein diet had lower total cholesterol levels when compared to those with a balanced or a high carbohydrate diet (177.1±31.6 mg/dl vs 215.8±37 mg/dl vs 200.5±27.2 mg/dl respectively; P=0.037). Atherogenic index was lower in these patients (1.8±1.3 vs 2.4±1.1 vs 2.6±1.3; P=0.032). Fish was the main source of proteins in high protein diet group. With regard to inflammatory indexes, ESR and RCP were lower in patients with high protein diet, but DAS 28 score was lower in high carbohydrate diet group, but significant differences were not reached.

Conclusions: Metabolic benefits, at least on lipid profile, are more likely to be found in patients with PsA that follow a high protein diet when fish is the main source of protein intake, resulting in potential cardiovascular benefits linked to a lower prevalence of atherogenic dyslipidemia. However, diet habits were not linked to lower inflammatory activity. Further prospective studies are needed to verify our observation.