Relationship of the Inflammatory Diet Status and Dietary Intake with Antimalarial Treatment in Systemic Lupus Rrythematosus: A Cross-Sectional Study

Abstract

Background: Systemic lupus erythematosus (SLE) is the prototype autoimmune disease with high inflammatory cytokine levels. In autoimmune conditions, diet could modify the inflammatory status, comorbidities and pharmacotherapy administered in SLE patients. The aim of this study was to assess the relationship of the inflammatory diet status and dietary intake with comorbidities and pharmacotherapy administered in SLE patients. Methods: A cross-sectional study was conducted in sixty-eight Mexican-Mestizo female SLE patients. Dietary intake was estimated from three 24h food records by Nutritionist Pro-Diet software and 27 food parameters were used to evaluate the inflammatory diet status by the normal dietary inflammatory index (DII®). Results: SLE patients presented a global pro-inflammatory diet status (DII: 0.71 ± 1.78). Chloroquine (CQ) administration was related to a pro-inflammatory diet status compared to hydroxychloroquine (HCQ) administration, which was related to an anti-inflammatory diet status (CQ= DII score: 1.385±1.327 vs. HCQ= DII score: 0.004±2.024; p=0.002). CQ administration conferred a pro-inflammatory DII score (β coefficient= 1.20; CI: 1–2.02; R2=0.11; p<0.01) and lower total-cholesterol (β coefficient=-29.2; CI: -4.03 to -54.5; R2=0.07; p<0.05); conversely, HCQ administration conferred an anti-inflammatory DII score (β coefficient= -1.29; CI: -0.46 to -2.12; R2=0.13; p<0.01). SLE patients with CQ administration had lower intake of energy and 12 nutrients evaluated (CQ vs. HCQ; p <0.05), and SLE patients with HCQ treatment had a better achievement ≥100% of daily dietary reference intake (DRI) of energy (HCQ 77% vs. CQ 52%; p=0.03), vitamin A (HCQ 65% vs. CQ 29%; p<0.01), cholesterol (HCQ 29% vs. CQ 3%; p<0.01), and fiber (HCQ 26% vs. CQ 6%; p=0.03).Conclusions: In SLE patients the CQ administration was related to a pro-inflammatory diet status and low total-cholesterol, and HCQ administration with an anti-inflammatory diet status and better dietary intake.