Population-based estimates of humoral autoimmunity from the U.S. National Health and Nutrition Examination Surveys, 1960–2014

Dillon, Charles; Weisman, Michael H.; Miller, Frederick W.

doi:10.1371/journal.pone.0226516

Cited by 17 publications

(11 citation statements)

References 76 publications

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“…The US population is aging and increased autoantibody and autoimmune disease prevalence is reported. 39 Because participants were older adults, the results might not generalize to autoimmune diseases that primarily have their onset in younger people. However, the pathogenesis of many of the specific autoimmune diseases observed (eg, rheumatoid arthritis and psoriasis) is similar in younger adults.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial

Hahn

Cook

Alexander

et al. 2022

BMJ

249

164

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Objective To investigate whether vitamin D and marine derived long chain omega 3 fatty acids reduce autoimmune disease risk. Design Vitamin D and omega 3 trial (VITAL), a nationwide, randomized, double blind, placebo controlled trial with a two-by-two factorial design. Setting Nationwide in the United States. Participants 25 871 participants, consisting of 12 786 men ≥50 years and 13 085 women ≥55 years at enrollment. Interventions Vitamin D (2000 IU/day) or matched placebo, and omega 3 fatty acids (1000 mg/day) or matched placebo. Participants self-reported all incident autoimmune diseases from baseline to a median of 5.3 years of follow-up; these diseases were confirmed by extensive medical record review. Cox proportional hazard models were used to test the effects of vitamin D and omega 3 fatty acids on autoimmune disease incidence. Main outcome measures The primary endpoint was all incident autoimmune diseases confirmed by medical record review: rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and all others. Results 25 871 participants were enrolled and followed for a median of 5.3 years. 18 046 self-identified as non-Hispanic white, 5106 as black, and 2152 as other racial and ethnic groups. The mean age was 67.1 years. For the vitamin D arm, 123 participants in the treatment group and 155 in the placebo group had a confirmed autoimmune disease (hazard ratio 0.78, 95% confidence interval 0.61 to 0.99, P=0.05). In the omega 3 fatty acids arm, 130 participants in the treatment group and 148 in the placebo group had a confirmed autoimmune disease (0.85, 0.67 to 1.08, P=0.19). Compared with the reference arm (vitamin D placebo and omega 3 fatty acid placebo; 88 with confirmed autoimmune disease), 63 participants who received vitamin D and omega 3 fatty acids (0.69, 0.49 to 0.96), 60 who received only vitamin D (0.68, 0.48 to 0.94), and 67 who received only omega 3 fatty acids (0.74, 0.54 to 1.03) had confirmed autoimmune disease. Conclusions Vitamin D supplementation for five years, with or without omega 3 fatty acids, reduced autoimmune disease by 22%, while omega 3 fatty acid supplementation with or without vitamin D reduced the autoimmune disease rate by 15% (not statistically significant). Both treatment arms showed larger effects than the reference arm (vitamin D placebo and omega 3 fatty acid placebo). Study registration ClinicalTrials.gov NCT01351805 and NCT01169259

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Section: Discussionmentioning

confidence: 99%

Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial

Hahn

Cook

Alexander

et al. 2022

BMJ

249

164

View full text Add to dashboard Cite

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“…The National Health and Nutrition Examination Survey (NHANES), which collects detailed data on diet, nutritional status, and chronic disease to inform nutrition and health policy, is the cornerstone for national nutrition monitoring in the US (29). The objectives of the current study were to present an analysis using this large, cross-sectional, nationallyrepresentative database to assess the intake status of v antioxidant micronutrients with a known role in CVD, and explore the effects of combined exposure to these antioxidants on CVD.…”

Section: Introductionmentioning

confidence: 99%

The Association Between Dietary Antioxidant Micronutrients and Cardiovascular Disease in Adults in the United States: A Cross-Sectional Study

Yin

Zhu

et al. 2022

Front. Nutr.

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Background: Antioxidant micronutrients represent an important therapeutic option for the treatment of oxidative stress-associated cardiovascular diseases (CVDs). However, few studies have evaluated the relationship between the levels of multiple dietary antioxidants and CVDs.Objective: The study therefore aimed to evaluate associations between dietary antioxidants and total and specific CVDs among a nationally representative sample of adults in the US.Design: In total, 39,757 adults (>20 years) were included in this cross-sectional study from the 2005–2018 National Health and Nutrition Examination Survey. We analyzed dietary recall of 11 antioxidant micronutrients in this population. Multivariate logistic and weighted quantile sum (WQS) regression were both applied to examine the relationships between these antioxidants, alone and in combination, with the prevalence of all CVDs and specific CVDs. The linearity of these correlations was also explored using restricted cubic spline (RCS) regression.Results: Multivariate logistic models showed that, compared with the lowest quartile, the levels of 11 antioxidants in the highest quartile were independently associated with decreased total CVD (all P < 0.05). The WQS index showed that, when considered together, the 11 micronutrients were negatively correlated with total CVD (P < 0.001) and five specific CVDs (all P < 0.05), and selenium had the strongest association (weight = 0.219) with total CVD. Moreover, the RCS model demonstrated that iron, zinc and copper were all negatively and non-linearly correlated with total CVD, while the eight other micronutrients had non-significant, linear, negative relationships with total CVD (P for non-linearity >0.05). A piecewise binary logistic regression analysis showed that the inflection points in the relationships between CVD and iron, zinc and copper were 7.71, 6.61, and 0.74 mg/day, respectively.Conclusions: Our findings suggested that high levels of combined dietary antioxidant micronutrients are associated with decreased prevalence of CVDs, and that selenium has the greatest contribution to this association.

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“…Specifically, we hypothesize that women have an evolutionarily conserved tendency toward enhanced B‐cell activation and production of higher levels of antibodies, which results in increased incidence of antibody‐driven autoimmune diseases. This hypothesis stems from our observation that women have more serum immunoglobulins (i.e., antibodies) than men at baseline (Butterworth et al., 1967; Crisp & Quinn, 2009; Dillon et al., 2020; Rowley & Mackay, 1969) and in response to challenges like infection or vaccination (Cook, 2008; Rowley & Mackay, 1969). While this difference may peak in the first two decades of life (Oyeyinka et al., 1984), women seem to have more absolute antibody levels than men lifelong (Crisp & Quinn, 2009; Dillon et al., 2020).…”

mentioning

confidence: 99%

“…This hypothesis stems from our observation that women have more serum immunoglobulins (i.e., antibodies) than men at baseline (Butterworth et al., 1967; Crisp & Quinn, 2009; Dillon et al., 2020; Rowley & Mackay, 1969) and in response to challenges like infection or vaccination (Cook, 2008; Rowley & Mackay, 1969). While this difference may peak in the first two decades of life (Oyeyinka et al., 1984), women seem to have more absolute antibody levels than men lifelong (Crisp & Quinn, 2009; Dillon et al., 2020). A recent study showed that women have not only more antibodies in general, but also autoantibodies (Dillon et al., 2020).…”

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confidence: 99%

Why women have more autoimmune diseases than men: An evolutionary perspective

Kronzer

Bridges

Davis

2020

Evolutionary Applications

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Women have up to a fourfold increase in risk for autoimmune disease compared to men. Many explanations have been proposed, including sex hormones, the X chromosome, microchimerism, environmental factors, and the microbiome. However, the mechanism for this autoimmune sex bias remains obscure. In this manuscript, we evaluate the hypothesis that qualitative or quantitative differences in circulating antibodies may explain, at least in part, the This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Population-based estimates of humoral autoimmunity from the U.S. National Health and Nutrition Examination Surveys, 1960–2014

Cited by 17 publications

References 76 publications

Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial

Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial

The Association Between Dietary Antioxidant Micronutrients and Cardiovascular Disease in Adults in the United States: A Cross-Sectional Study

Why women have more autoimmune diseases than men: An evolutionary perspective

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