POS0544 INFLUENCE OF EATING HABITS ON FRAILTY AMONG PATIENTS WITH RHEUMATOID ARTHRITIS: KURAMA COHORT
Authors: M. Katsushima, H. Minamino, M. Torii, M. Hashimoto, W. Yamamoto, R. Watanabe, K. Murakami, K. Murata, M. Tanaka, H. Ito, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder that contributes to accelerating frailty, a clinical state of increased vulnerability due to declined physiological function. Although accumulating evidence suggests the importance of nutritional therapy for frailty in the general population, there is little evidence on dietary recommendations for preventing frailty in patients with RA. Objectives: The present study aimed to reveal clinical associations between frailty status, eating habits and RA disease activity. Methods: We conducted a cross-sectional study of 306 female outpatients enrolled from the KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) cohort database. The participants were classified into three groups (robust, prefrail and frail) according to simplified frailty scale (SOF index), and dietary data were collected using a self-reported food frequency questionnaire as previously reported. We performed multivariate logistic analyses for the presence of frailty/prefrailty with or without eating habits. Results: Frail group showed physical decline such as decreased skeletal muscle index, hand grip strength and walking speed, and DAS28-ESR in the frail group was significantly higher compared to that in the others. In multivariate logistic analysis, the presence of frailty/prefrailty was correlated with DAS28-ESR (OR 1.71, p =0.00004) and methotrexate use (OR 0.47, p =0.0097). Cochran-Armitage trend test also showed that the intake frequency of five ingredients (meat, fish, milk, fruits and vegetables) was inversely associated with the prevalence of frailty/prefrailty. In additional multivariate logistic analyses with dietary habits, habitual intake of fish (at least three times per week), rather than meat or other foods, was independently correlated with the presence of frailty/prefrailty (OR 0.33, p =0.00027). Conclusion: Our results suggest that habitual intake of fish, rather than meat or other foods, may be beneficial in preventing frailty among RA patients. References: [1]Ferrucci, L. &amp; Fabbri, E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol 15, 505-522, doi:10.1038/s41569-018-0064-2 (2018). [2]Hernandez Morante, J. J., Gomez Martinez, C. &amp; Morillas-Ruiz, J. M. Dietary factors associated with frailty in old adults: a review of nutritional interventions to prevent frailty development. Nutrients 11, doi:10.3390/nu11010102 (2019). Table 1. Multivariate logistic analysis for RA patients with prefrailty or frailty variables including eating habits Fish + Meat All OR (95% CI ) P value OR (95% CI ) P value DAS28-ESR 1.78 (1.34 - 2.37 ) 0.00003 1.73 (1.30 - 2.30 ) 0.00009 MTX use 0.43 (0.23 - 0.79 ) 0.0055 0.42 (0.23 - 0.78 ) 0.0050 Age (1 year) 1.02 (1.00 - 1.05 ) 0.037 1.03 (1.01 - 1.06 ) 0.0015 PSL use 1.23 (0.69 - 2.21) 0.49 1.22 (0.67 - 2.20) 0.51 Duration of RA (1 year) 1.00 (0.98 - 1.02) 0.72 1.00 (0.98 - 1.02) 0.84 Body mass index 1.00 (0.93 - 1.07) 0.98 0.99 (0.92 - 1.07) 0.85 Biological agents use 1.02 (0.60 - 1.72) 0.94 1.04 (0.62 - 1.77) 0.87 Fish dish 0.31 (0.17 - 0.55 ) 0.00004 0.33 (0.18 - 0.61 ) 0.00027 Meat dish 0.86 (0.49 - 1.50) 0.60 0.89 (0.51 - 1.57) 0.69 Milk 0.71 (0.41 - 1.24) 0.23 Vegetable 0.95 (0.47 - 1.93) 0.89 Fruits 0.77 (0.41 - 1.42) 0.40 Figure 1. The prevalence of prefrailty or frailty for subjects by intake frequency Acknowledgements: We thank S. Nakagawa and M. Iida for technical assistance. Disclosure of Interests: Masao Katsushima: None declared, Hiroto Minamino: None declared, Mie Torii: None declared, Motomu Hashimoto Speakers bureau: M.H. receives grants and/or speaker fees from Bristol-Meyers, Eisai, Eli Lilly, and Tanabe Mitsubishi., Grant/research support from: M.H. belongs to the department financially supported by Nagahama City, Shiga, Japan, Toyooka City, Hyogo, Japan and five pharmaceutical companies (Tanabe-Mitsubishi, Chugai, UCB Japan, Ayumi and Asahi-Kasei). KURAMA cohort study is supported by a grant from Daiichi Sankyo Co. Ltd., Wataru Yamamoto: None declared, Ryu Watanabe Grant/research support from: R.W. belongs to the department that is financially supported by Nagahama City, Shiga, Japan, Toyooka City, Hyogo, Japan and five pharmaceutical companies (Tanabe-Mitsubishi, Chugai, UCB Japan, Ayumi and Asahi-Kasei). KURAMA cohort study is supported by a grant from Daiichi Sankyo Co. Ltd., Kosaku Murakami: None declared, Koichi Murata Grant/research support from: K.M. belongs to the department that is financially supported by Nagahama City, Shiga, Japan, Toyooka City, Hyogo, Japan and five pharmaceutical companies (Tanabe-Mitsubishi, Chugai, UCB Japan, Ayumi and Asahi-Kasei). KURAMA cohort study is supported by a grant from Daiichi Sankyo Co. Ltd., Masao Tanaka Grant/research support from: M.T. belongs to the department that is financially supported by Nagahama City, Shiga, Japan, Toyooka City, Hyogo, Japan and five pharmaceutical companies (Tanabe-Mitsubishi, Chugai, UCB Japan, Ayumi and Asahi-Kasei). KURAMA cohort study is supported by a grant from Daiichi Sankyo Co. Ltd., Hiromu Ito Speakers bureau: H.I. receives a research grant and/or speaker fee from Bristol-Myers, Eisai, Mochida, Taisho, and Asahi-Kasei., Grant/research support from: H.I. belongs to the department that is financially supported by Nagahama City, Shiga, Japan, Toyooka City, Hyogo, Japan and five pharmaceutical companies (Tanabe-Mitsubishi, Chugai, UCB Japan, Ayumi and Asahi-Kasei). KURAMA cohort study is supported by a grant from Daiichi Sankyo Co. Ltd., Akio Morinobu Speakers bureau: A.M. has received speaking fees and/or research grants from Eli Lilly Japan K.K., Ono Pharmaceutical Co., Pfizer Inc., UCB Japan, AbbVie G.K., Asahi Kasei Pharma and Chugai Pharmaceutical Co. Ltd., Grant/research support from: A.M. has received speaking fees and/or research grants from Eli Lilly Japan K.K., Ono Pharmaceutical Co., Pfizer Inc., UCB Japan, AbbVie G.K., Asahi Kasei Pharma and Chugai Pharmaceutical Co. Ltd.