Intakes of Vitamin B6 and Dietary Fiber and Clinical Course of Systemic Lupus Erythematosus: A Prospective Study of Japanese Female Patients

Abstract

BackgroundIntakes of selected vitamins and dietary fiber may influence the clinical course of systemic lupus erythematosus (SLE). Using a cohort study method, we investigated the associations of dietary intake of vitamin B6 and B12, folate, and dietary fiber with the risk of active disease and atherosclerotic vascular events in SLE.MethodsThe study included female SLE patients in the Miyagi Lupus Cohort, which was founded in 1995. Dietary nutrients at baseline were estimated by a semiquantitative food frequency questionnaire. The association of each nutrient intake with the risk of active disease was investigated in 216 patients who had inactive disease at baseline. The association with atherosclerotic vascular events was assessed in 196 women who had inactive disease and no history of atherosclerotic diseases at baseline.ResultsForty-three cases of active disease were identified during 9966 person-months of follow-up (1995–1999). During 19 575 person-months of follow-up (1995–2005), 20 atherosclerotic vascular events were documented. The Cox proportional hazards model revealed an inverse association between vitamin B6 intake and the risk of active disease (hazard ratio for the highest as compared with the lowest tertile, 0.41; 95% confidence interval, 0.18–0.97; P for trend = 0.04). An inverse association was also found for dietary fiber intake (P for trend = 0.01). However, no significant association was observed between intakes of these nutrients and the risk of atherosclerotic vascular events.ConclusionsHigher intake of vitamin B6 and dietary fiber may prevent the occurrence of active disease in SLE.

Updated Review of Complementary and Alternative Medicine Treatments for Systemic Lupus Erythematosus

“…Dietary vitamins were not associated with risk for vascular events during the follow-up period. The same research group also found dietary vitamin B6 to be inversely associated with risk for active disease but not atherosclerotic events in a cohort of women with inactive disease at baseline [22]. These studies highlight the importance of lifestyle factors such as a diet rich in antioxidants for SLE patients.…”

Dieta e aspectos nutricionais no lúpus eritematoso sistêmico

“…The possibility of supplementation should also be considered. 62 The study by Minami et al 61 has shown the association of high doses of vitamin B6 and folate with a lower severity of SLE in Japanese patients, regardless of the non-dietary factors. The studyby Ardoin et al 63 has shown that niacin reduces TG and LDL-C levels by 23% and 30%, respectively, in children with dyslipidemia, although it does not signifi cantly affect HDL-C levels.…”

“…The higher plasma levels of homocysteine might be associated with atherosclerosis in SLE, which reinforces the need for a higher consumption of vitamins B6 and B12 (in addition to folate), which are important cofactors in its metabolism and promote a reduction in homocysteine levels. 61 In addition, those vitamins also infl uence the serum levels of some infl ammatory markers, such as cytokines and C-reactive protein (CRP). 61 Some studies have shown that the consumption of vitamin B12-and folate-defi cient diets has caused a plasma increase in homocysteine in patients with SLE.…”

“…61 In addition, those vitamins also infl uence the serum levels of some infl ammatory markers, such as cytokines and C-reactive protein (CRP). 61 Some studies have shown that the consumption of vitamin B12-and folate-defi cient diets has caused a plasma increase in homocysteine in patients with SLE. Thus, it has been suggested that patients on a hypolipid diet (indicated for SLE) should increase their consumption of cereals fortifi ed with those nutrients, in addition to vegetables and fruits.…”

“…This change in the pool of biliary acids, along with the intake of viscous fi bers, depress cholesterol synthesis. 61,64 Simultaneously, inulin, oligosaccharides, resistant starch, and other fi bers increase mineral absorption, especially that of calcium. 67 The diet therapeutic intervention to control hypercholesterolemia and MS in SLE should emphasize the importance of consuming fi ber-rich foods, especially the soluble ones (found in oat, fruits and pulses) to control dyslipidemia.…”