Marine ω-3, vitamin D levels, disease outcome and periodontal status in rheumatoid arthritis outpatients

Highlights

• Periodontitis was most prevalent in patients with rheumatoid arthritis (RA) who were seropositive for rheumatoid factor and/or anticitrullinated protein antibody.

• Seafood intake in accordance with the recommendation was related to lower RA symptoms (modified health assessment questionnaire [MHAQ], visual analog scale [VAS]).

• A favorable ω-3 index (>8) was associated with the use of ω-3 supplements.

• An ω-3 index >8 was also related to a more desirable VAS score and lower probing depth.

• Overall vitamin D status was good and did not differ for RA and periodontal measurements.

Abstract

Objectives

Marine ω-3 fatty acids (FAs) and Vitamin D (VitD) are reportedly capable of down-regulating inflammation in rheumatoid arthritis (RA) and periodontal disease. This study was undertaken to relate marine FA and VitD status to RA disease status and periodontal conditions.

Methods

RA outpatients (age ≥35 y) were consecutively recruited. Rheumatologic clinical data were collected and periodontal status obtained. A food frequency questionnaire was used to estimate fish and supplement intake. FA profiles in whole-blood and serum VitD levels were determined.

Results

A total of 78 RA patients (age 57 ± 12 y, disease duration 15 ± 11 y) were included, 58% had active RA. Periodontitis was diagnosed in 82% of the patients, 18% had severe periodontitis. Seropositivity for rheumatoid factor and/or anticitrullinated protein antibodies was related to higher prevalence of periodontitis (P = 0.008). Seafood intake in accordance with nutritional recommendations was associated with better RA disease outcome (largest P = 0.008). An ω-3 index >8, present in 14% of the patients, correlated with a more desirable patient global health assessment scored on a visual analog scale (VAS; P = 0.004), lower periodontal probing depth (PD; P = 0.021), and ω-3 supplementation (P = 0.001). Serum VitD levels >50 nmol/L were found in 89%, of these 48% had VitD levels ≥75 nmol/L, no differences were found for RA disease activity and periodontal measurements.

Conclusions

Seropositive RA patients had a higher prevalence of periodontitis than seronegative patients. An ω-3 index >8 was related to ω-3 supplementation and more desirable VAS and lower PD. VitD status was satisfactory for most patients and was not associated with differences in RA severity or periodontal diagnosis.