健康饮食模式与类风湿关节炎风险：一项系统回顾和荟萃分析

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-08-29 DOI:10.1016/j.semarthrit.2025.152825

Elena K Joerns , Jeffrey A Sparks , Cynthia J Chelf , Cynthia S Crowson , John M Davis III , Vanessa L Kronzer

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引用次数: 0

摘要

目的：我们旨在确定健康饮食模式与类风湿关节炎（RA）发病的关联程度。方法我们在PROSPERO杂志（CRD42025645056）上注册了该系统评价和荟萃分析。纳入标准是经过验证的饮食（抗炎饮食、地中海饮食、停止高血压的饮食方法（DASH）和/或健康饮食指数[HEI]）；经过验证的RA定义；RA发病前的饮食暴露；随机对照试验、队列或病例对照设计。我们检索了截至2025年2月3日的CENTRAL， Embase， MEDLINE, Scopus， Web of Science和灰色文献。我们使用纽卡斯尔-渥太华量表评估偏倚风险。meta分析采用随机效应模型，将校正优势比（OR）与95%可信区间（CI）结合起来。对于异质性，我们计算I2并进行亚组分析。我们使用GRADE评估证据的确定性。结果我们纳入了12项病例对照和队列研究（其中8项为独立研究）。3项研究为低偏倚风险，3项为中等偏倚风险，3项为高偏倚风险，3项为极高偏倚风险。健康的整体饮食模式与RA发病风险降低相关（OR 0.54, 95% CI 0.32-0.91, I2= 81%）。仅纳入偏倚风险最低的研究也与RA风险降低相关（OR 0.84, 95% CI 0.76-0.94, I2= 0%）。抗炎模式（OR 0.56, 95% CI 0.31-0.99），地中海模式（OR 0.88, 95% CI 0.78-0.99）和HEI模式（OR 0.60, 95% CI 0.25-1.47）均显示RA的较低点估计。由于研究的观察性质，这些结果的总体确定性水平是中等的。结论在观察性研究中，健康的饮食模式与RA发病风险降低相关。

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Healthy dietary pattern and risk of rheumatoid arthritis: A systematic review and meta-analysis

Objectives

We aimed to determine the degree to which a healthy dietary pattern is associated with incident rheumatoid arthritis (RA).

Methods

We registered this systematic review and meta-analysis in PROSPERO (CRD42025645056). Inclusion criteria were validated diet (anti-inflammatory, Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and/or healthy eating index [HEI]); validated RA definition; dietary exposure preceding RA; and randomized controlled trial, cohort, or case-control design. We searched CENTRAL, Embase, MEDLINE, Scopus, Web of Science, and grey literature as of 2/3/2025. We assessed risk of bias using the Newcastle-Ottawa Scale. Meta-analyses combined adjusted odds ratios (OR) with 95 % confidence interval (CI) for incident RA using random effects models. For heterogeneity, we calculated I² and performed subgroup analyses. We assessed certainty of evidence using GRADE.

Results

We included 12 case-control and cohort studies (8 of which were independent) in the review. Three studies were low risk of bias, 3 moderate, 3 high, and 3 very high. Healthy overall dietary pattern was associated with lower risk of incident RA (OR 0.54, 95 % CI 0.32–0.91, I²=81 %). Including only studies with the lowest risk of bias was also associated with lower RA risk (OR 0.84, 95 % CI 0.76–0.94, I²=0 %). Anti-inflammatory (OR 0.56, 95 % CI 0.31–0.99), Mediterranean (OR 0.88, 95 % CI 0.78–0.99), and HEI (OR 0.60, 95 % CI 0.25–1.47) patterns all showed lower point estimates for RA. Overall level of certainty in these results was moderate due to the studies’ observational nature.

Conclusions

In observational studies, healthy dietary pattern is associated with reduced risk of incident RA.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.