Effects of nutritional supplements and dietary interventions on rheumatoid arthritis: An umbrella review of meta-analyses of randomized controlled trials

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews Pub Date : 2025-03-05 DOI:10.1016/j.autrev.2025.103792

Xue-Er Cheng , Xiao Hu , Jian Tang , Qian-Qian Shi , Sheng Li , Yi-Sheng He , Man Ge , Jin-Hui Tao , Peng Wang , Hai-Feng Pan

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引用次数: 0

Abstract

Backgrounds

The effects of nutritional supplements and dietary interventions on rheumatoid arthritis (RA) are still unclear.

Objectives

This study aimed to evaluate the impact of nutritional supplements and dietary interventions on RA patients.

Methods

The online databases of PubMed, Web of Science, Embase, and Cochrane Library were used to search the relevant literature from inception to December 2024. Meta-analyses with the inclusion of randomized controlled trials were selected to assess the effects of nutritional supplements or dietary interventions on RA. We accessed the methodological quality of included reviews using AMSTAR 2 and evaluated the quality of evidence for intervention effects using GRADE. Data synthesis and analysis were used by R 4.4.1 and STATA 17.

Results

A total of 14 articles were included, evaluating the effects of nutritional supplements and dietary interventions on RA management. Among these, 3 studies were rated as high quality, 6 as low quality, and 5 as critically low quality by AMSTAR2. The quality of evidence for intervention effects ranges from low to very low quality. The interventions assessed included polyunsaturated fatty acids (PUFAs), probiotics, total glucosides of paeony (TGP), anti-inflammatory diets (AIDs), and others. TGP was the only intervention to significantly reduce both the disease activity score and erythrocyte sedimentation rate, although the quality of evidence for these effects was low. Probiotics contributed to significant reductions in C-reactive protein and visual analogue scale scores, with both outcomes rated as low quality. PUFAs demonstrated significant improvements in tender joint count, swollen joint count, and morning stiffness, though, like the other interventions, these effects were also rated as low quality.

Conclusion

There was relatively strong evidence supporting that PUFAs, probiotics, TGP, and AIDs may show some benefits on RA. However, the low quality of evidence highlights the need for further high-quality research and real-world evidence to confirm their effectiveness.

查看原文本刊更多论文

营养补充剂和饮食干预对类风湿关节炎的影响：随机对照试验的荟萃分析综述。

背景：营养补充剂和饮食干预对类风湿关节炎（RA）的影响尚不清楚。目的：本研究旨在评估营养补充剂和饮食干预对RA患者的影响。方法：利用PubMed、Web of Science、Embase、Cochrane Library等在线数据库，检索成立至2024年12月的相关文献。荟萃分析纳入随机对照试验来评估营养补充剂或饮食干预对类风湿关节炎的影响。我们使用AMSTAR 2评估纳入综述的方法学质量，并使用GRADE评估干预效果的证据质量。数据综合分析采用r4.4.1和STATA 17。结果：共纳入14篇文章，评估营养补充剂和饮食干预对RA管理的影响。其中，3项研究被AMSTAR2评为高质量，6项为低质量，5项为极低质量。干预效果的证据质量从低到极低。评估的干预措施包括多不饱和脂肪酸（PUFAs）、益生菌、芍药总糖苷（TGP）、抗炎饮食（AIDs）等。TGP是唯一能显著降低疾病活动性评分和红细胞沉降率的干预措施，尽管这些影响的证据质量很低。益生菌有助于显著降低c反应蛋白和视觉模拟评分，这两项结果都被评为低质量。PUFAs在压痛关节计数、肿胀关节计数和晨僵方面表现出显著的改善，尽管与其他干预措施一样，这些效果也被评为低质量。结论：有较强的证据支持PUFAs、益生菌、TGP和AIDs可能对RA有一定的益处。然而，低质量的证据表明需要进一步的高质量研究和真实世界的证据来证实其有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Autoimmunity reviews 医学-免疫学

CiteScore

24.70

自引率

4.40%

发文量

164

审稿时长

21 days

期刊介绍： Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.