Introduction
Methods
Study design and participants
Plasma fatty acids detection
Data collection and outcomes
Statistical analysis
Results
Patient baseline characteristics
Characteristic | Total (n = 296) | Male (n = 228) | Female (n = 68) | p-value |
---|---|---|---|---|
Age (years) | 51.14 ± 15.45 | 50.88 ± 15.23 | 52.00 ± 16.25 | 0.521 |
Education levels | ||||
High school or lower | 164 (57.34) | 121 (54.26) | 43 (68.25) | 0.047 |
College or above | 122 (42.66) | 102 (45.74) | 20 (31.75) | |
BMI (kg/m2) | 25.23 ± 3.98 | 25.57 ± 3.93 | 24.08 ± 3.98 | 0.006 |
< 18.50 | 7 (2.37) | 4 (1.76) | 3 (4.41) | 0.139 |
18.50–23.99 | 112 (37.97) | 80 (35.24) | 32 (47.06) | |
23.99–28.00 | 118 (40.00) | 97 (42.73) | 21 (30.88) | |
≥ 28.00 | 58 (19.66) | 46 (20.26) | 12 (17.65) | |
Smoker, ever (yes) | 169 (57.09) | 163 (71.49) | 6 (8.82) | < 0.0001 |
Alcohol use, ever (yes) | 108 (36.61) | 106 (46.70) | 2 (2.94) | < 0.0001 |
Psoriasis duration (years) | 15.41 ± 12.43 | 15.11 ± 12.78 | 16.35 ± 11.3 | 0.198 |
Sex differences in psoriasis severity and plasma PUFAs concentrations at baseline
Characteristic | Total (n = 296) | Male (n = 228) | Female (n = 68) | p-value |
---|---|---|---|---|
ClinROs | ||||
PASI | 11.5 (8.5, 15.5) | 12.0 (9.3, 16.8) | 9.8 (7.5, 12.0) | 0.001 |
BSA | 13.0 (9.5, 21.5) | 13.6 (10.0, 24.0) | 10.9 (7.5, 14.8) | < 0.0001 |
PGA | 3.0 (2.7, 3.3) | 3.9 (2.7, 3.5) | 2.7 (2.3, 3.0) | 0.001 |
PROs | ||||
PtGA | 7.0 (5.0, 8.0) | 7.0 (5.0, 8.0) | 7.0 (5.0, 9.0) | 0.708 |
DLQI | 8.0 (4.0, 14.0) | 8.0 (4.0, 14.0) | 9.0 (5.0, 14.0) | 0.676 |
Plasma PUFAs (mol %) | ||||
Omega-3 | ||||
α-Linolenic acid (18:3n3) | 1.95 (1.44, 2.90) | 1.99 (1.44, 2.99) | 1.84 (1.34, 2.38) | 0.206 |
Eicosapentaenoic acid (20:5n3) | 0.69 (0.51, 1.00) | 0.67 (0.50, 0.99) | 0.71 (0.56, 1.05) | 0.352 |
Docosahexaenoic acid (22:6n3) | 4.42 (3.69, 5.36) | 4.34 (3.53, 5.30) | 4.62 (4.13, 5.72) | 0.008 |
Omega-3 PUFAs | 7.44 (6.36, 8.74) | 7.34 (6.28, 8.67) | 7.76 (6.47, 8.93) | 0.159 |
Omega-6 | ||||
Linoleic acid (18:2n6-cis) | 23.74 (21.98, 25.54) | 23.74 (22.04, 25.56) | 23.69 (21.60, 25.19) | 0.343 |
Eicosadienoic acid (20:2n6) | 0.71 (0.62, 0.79) | 0.71 (0.62, 0.80) | 0.70 (0.62, 0.76) | 0.167 |
Dohomo-γ-linolenic acid (20:3n6) | 0.06 (0.05, 0.08) | 0.06 (0.05, 0.08) | 0.06 (0.05, 0.08) | 0.520 |
Arachidonic acid (20:4n6) | 13.17 (11.03, 15.44) | 12.86 (10.65, 15.20) | 13.61 (11.91, 16.17) | 0.032 |
Omega-6 PUFAs | 38.21 (35.39, 40.80) | 37.96 (35.34, 40.80) | 38.70 (35.94, 40.95) | 0.379 |
Omega-6/3 ratio | 5.01 (4.28, 6.17) | 5.08 (4.28, 6.25) | 4.89 (4.27, 6.09) | 0.313 |
Associations of plasma PUFAs levels with psoriasis severity at baseline
PUFAs (mol %) | PASI (n = 228) | BSA (n = 227) | PGA (n = 228) | PtGA (n = 213) | DLQI (n = 216) | |||||
---|---|---|---|---|---|---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | |
Omega-3 | ||||||||||
α-Linolenic acid (18:3n3) | − 0.46 (− 1.20, 0.28) | 0.220 | − 0.83 (− 2.46, 0.80) | 0.318 | 0.00 (− 0.07. 0.08) | 0.917 | − 0.02 (− 0.25, 0.21) | 0.866 | 1.20 (0.52, 1.89) | 0.0005 |
Eicosapentaenoic acid (20:5n3) | 0.78 (-0.82, 2.37) | 0.340 | 1.45 (− 2.06, 4.96) | 0.418 | − 0.08 (− 0.23, 0.08) | 0.315 | − 0.12 (− 0.62, 0.37) | 0.630 | − 0.67 (− 2.16, 0.82) | 0.375 |
Docosahexaenoic acid (22:6n3) | 0.48 (− 0.16, 1.13) | 0.144 | 0.91 (− 0.52, 2.33) | 0.211 | − 0.00 (− 0.07, 0.06) | 0.916 | 0.03 (− 0.17, 0.23) | 0.780 | − 0.11 (− 0.72, 0.50) | 0.731 |
Omega-3 PUFAs | 0.13 (− 0.29, 0.55) | 0.544 | 0.24 (− 0.74, 1.22) | 0.630 | − 0.01 (− 0.05, 0.04) | 0.773 | − 0.00 (− 0.14, 0.13) | 0.967 | 0.33 (− 0.09, 0.75) | 0.123 |
Omega-6 | ||||||||||
Linoleic acid (18:2n6-cis) | − 0.06 (− 0.37, 0.25) | 0.695 | − 0.34 (− 1.02, 0.35) | 0.337 | 0.01 (− 0.02, 0.04) | 0.575 | − 0.00 (− 0.10, 0.09) | 0.953 | 0.25 (− 0.05, 0.54) | 0.097 |
Eicosadienoic acid (20:2n6) | 7.10 (0.61, 13.60) | 0.032 | 14.90 (0.56, 29.24) | 0.042 | 0.88 (0.26, 1.51) | 0.0058 | 1.34 (− 0.67, 3.35) | 0.190 | 1.08 (− 5.13, 7.28) | 0.734 |
Dohomo-γ-linolenic acid (20:3n6) | 36.96 (− 6.15, 80.06) | 0.093 | 71.81 (− 23.26, 166.88) | 0.139 | 1.91 (− 2.31, 6.13) | 0.375 | − 2.50 (− 15.68, 10.67) | 0.710 | 3.73 (− 37.16, 44.63) | 0.858 |
Arachidonic acid (20:4n6) | 0.12 (− 0.13, 0.36) | 0.360 | 0.08 (− 0.47, 0.63) | 0.773 | 0.00 (− 0.02, 0.03) | 0.771 | − 0.01 (− 0.09, 0.07) | 0.792 | − 0.35 (− 0.58, − 0.11) | 0.0039 |
Omega-6 PUFAs | 0.07 (− 0.15, 0.29) | 0.536 | − 0.09 (− 0.58, 0.40) | 0.726 | 0.01 (− 0.01, 0.03) | 0.448 | − 0.01 (− 0.08, 0.06) | 0.814 | − 0.14 (− 0.35, 0.07) | 0.193 |
Omega-6/3 ratio | 0.12 (− 0.32, 0.56) | 0.597 | − 0.00 (− 1.30, 1.29) | 0.997 | 0.02 (− 0.03, 0.08) | 0.421 | 0.02 (− 0.17, 0.21) | 0.836 | − 0.49 (− 1.07, 0.09) | 0.095 |
PUFAs (mol %) | PASI (n = 68) | BSA (n = 68) | PGA (n = 68) | PtGA (n = 64) | DLQI (n = 64) | |||||
---|---|---|---|---|---|---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | β (95% CI) | p | |
Omega-3 | ||||||||||
α-Linolenic acid (18:3n3) | 0.31 (− 0.95, 1.57) | 0.635 | 0.65 (− 1.86, 3.16) | 0.610 | − 0.01 (− 0.19, 0.16) | 0.883 | 0.10 (− 0.45, 0.66) | 0.717 | − 0.36 (− 2.07, 1.34) | 0.675 |
Eicosapentaenoic acid (20:5n3) | − 2.67 (− 5.21, − 0.14) | 0.039 | − 5.84 (− 10.86, − 0.81) | 0.023 | 0.27 (− 0.09, 0.63) | 0.144 | − 0.99 (− 2.08, 0.10) | 0.074 | − 2.91 (− 6.26, 0.43) | 0.088 |
Docosahexaenoic acid (22:6n3) | − 0.92 (− 1.72, − 0.12) | 0.024 | − 2.02 (− 3.61, − 0.44) | 0.011 | 0.04 (− 0.07, 0.16) | 0.449 | − 0.19 (− 0.55, 0.17) | 0.297 | − 0.85 (− 1.94, 0.24) | 0.127 |
Omega-3 PUFAs | − 0.65 (− 1.28, − 0.02) | 0.045 | − 1.42 (− 2.67, − 0.17) | 0.023 | 0.04 (− 0.05, 0.13) | 0.383 | − 0.15 (− 0.43, 0.13) | 0.288 | − 0.78 (− 1.61, 0.06) | 0.068 |
Omega-6 | ||||||||||
Linoleic acid (18:2n6-cis) | 0.27 (− 0.18, 0.72) | 0.243 | 0.84 (− 0.05, 1.73) | 0.063 | − 0.02 (− 0.08, 0.05) | 0.581 | 0.12 (− 0.08, 0.32) | 0.246 | − 0.24 (− 0.86, 0.38) | 0.447 |
Eicosadienoic acid (20:2n6) | 5.41 (− 4.84, 15.66) | 0.301 | 6.37 (− 14.20, 26.95) | 0.544 | 1.02 (− 0.41, 2.45) | 0.161 | 3.06 (− 1.37, 7.50) | 0.176 | 1.67 (− 12.08, 15.42) | 0.812 |
Dohomo-γ-linolenic acid (20:3n6) | − 12.40 (− 62.94, 38.14) | 0.631 | − 29.57 (− 130.28, 71.13) | 0.565 | 4.17 (− 2.85, 11.19) | 0.245 | − 4.19 (− 26.40, 18.02) | 0.711 | 27.32 (− 40.68, 95.32) | 0.431 |
Arachidonic acid (20:4n6) | − 0.09 (− 0.50, 0.31) | 0.644 | − 0.26 (− 1.06, 0.54) | 0.523 | − 0.03 (− 0.08, 0.03) | 0.382 | − 0.05 (− 0.22, 0.13) | 0.598 | − 0.27 (− 0.79, 0.26) | 0.318 |
Omega-6 PUFAs | 0.08 (− 0.25, 0.41) | 0.628 | 0.27 (− 0.39, 0.92) | 0.424 | − 0.02 (− 0.07, 0.02) | 0.286 | 0.03 (− 0.11, 0.18) | 0.672 | − 0.32 (− 0.76, 0.13) | 0.163 |
Omega-6/3 ratio | 0.76 (− 0.14, 1.67) | 0.082 | 1.80 (0.01, 3.59) | 0.049 | − 0.08 (− 0.20, 0.05) | 0.244 | 0.25 (− 0.14, 0.65) | 0.210 | 0.86 (− 0.36, 2.07) | 0.166 |
Dose-response associations between Omega-3 PUFAs levels and clinical scores at baseline
Associations between plasma PUFAs levels and PASI scores/response at week 12
PUFAs (mol %) | PASI scores | PASI 75 | PASI 90 | PASI 100 | ||||
---|---|---|---|---|---|---|---|---|
β (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Omega-3 | ||||||||
α-Linolenic acid (18:3n3) | − 0.18 (− 0.82, 0.46) | 0.580 | 1.03 (0.79, 1.35) | 0.840 | 0.98 (0.75, 1.30) | 0.910 | 0.90 (0.64, 1.27) | 0.545 |
Eicosapentaenoic acid (20:5n3) | 0.14 (− 1.26, 1.54) | 0.840 | 1.10 (0.60, 2.01) | 0.767 | 1.55 (0.85, 2.84) | 0.157 | 1.20 (0.63, 2.28) | 0.586 |
Docosahexaenoic acid (22:6n3) | 0.23 (− 0.35, 0.81) | 0.437 | 1.01 (0.79, 1.30) | 0.908 | 1.05 (0.83, 1.34) | 0.681 | 1.25 (0.95, 1.64) | 0.117 |
Omega-3 PUFAs | 0.05 (− 0.34, 0.43) | 0.810 | 1.02 (0.87, 1.20) | 0.781 | 1.05 (0.90, 1.23) | 0.541 | 1.08 (0.90, 1.30) | 0.391 |
Omega-6 | ||||||||
Linoleic acid (18:2n6-cis) | − 0.07 (− 0.35, 0.20) | 0.597 | 1.01 (0.90, 1.14) | 0.867 | 1.04 (0.92, 1.17) | 0.548 | 1.10 (0.95, 1.27) | 0.209 |
Eicosadienoic acid (20:2n6) | − 1.10 (− 7.09, 4.88) | 0.718 | 6.94 (0.50, 97.12) | 0.150 | 2.04 (0.17, 24.93) | 0.578 | 1.70 (0.10, 30.50) | 0.717 |
Dohomo-γ-linolenic acid (20:3n6) | 27.88 (− 11.57, 67.33) | 0.166 | 0.02 (0.00, 358272.69) | 0.645 | 0.00 (0.00, 64155.96) | 0.452 | 0.00 (0.00, 2955.26) | 0.202 |
Arachidonic acid (20:4n6) | 0.10 (− 0.12, 0.33) | 0.365 | 0.99 (0.90, 1.08) | 0.815 | 1.03 (0.94, 1.14) | 0.504 | 1.10 (0.99, 1.23) | 0.089 |
Omega-6 PUFAs | 0.04 (− 0.16, 0.24) | 0.676 | 1.00 (0.92, 1.08) | 0.963 | 1.05 (0.96, 1.14) | 0.287 | 1.14 (1.03, 1.27) | 0.014 |
Omega-6/3 ratio | 0.12 (− 0.62, 0.38) | 0.634 | 0.99 (0.81, 1.22) | 0.932 | 1.07 (0.87, 1.32) | 0.523 | 0.99 (0.77, 1.26) | 0.908 |
PUFAs (mol %) | PASI scores | PASI 75 | PASI 90 | PASI 100 | ||||
---|---|---|---|---|---|---|---|---|
β (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Omega-3 | ||||||||
α-Linolenic acid (18:3n3) | − 0.20 (− 1.01, 0.61) | 0.627 | 1.76 (0.65, 4.78) | 0.268 | 1.63 (0.73, 3.60) | 0.231 | 1.04 (0.46, 2.34) | 0.933 |
Eicosapentaenoic acid (20:5n3) | 0.58 (− 1.37, 2.53) | 0.560 | 0.16 (0.02, 1.41) | 0.099 | 0.19 (0.03, 1.50) | 0.116 | 0.47 (0.06, 3.90) | 0.488 |
Docosahexaenoic acid (22:6n3) | 0.06 (− 0.45, 0.58) | 0.812 | 0.55 (0.31, 0.99) | 0.047 | 0.38 (0.17, 0.84) | 0.018 | 0.54 (0.25, 1.18) | 0.121 |
Omega-3 PUFAs | 0.02 (− 0.42, 0.45) | 0.945 | 0.67 (0.41, 1.11) | 0.119 | 0.66 (0.43, 1.02) | 0.060 | 0.71 (0.43, 1.16) | 0.170 |
Omega-6 | ||||||||
Linoleic acid (18:2n6-cis) | 0.00 (− 0.25, 0.26) | 0.991 | 1.04 (0.79, 1.38) | 0.781 | 1.02 (0.81, 1.28) | 0.854 | 0.96 (0.74, 1.23) | 0.742 |
Eicosadienoic acid (20:2n6) | 5.60 (− 0.57, 11.76) | 0.076 | 0.01 (0.00, 11.86) | 0.195 | 0.00 (0.00, 2.54) | 0.093 | 0.06 (0.00, 47.05) | 0.407 |
Dohomo-γ-Linolenic Acid (20:3n6) | 34.82 (7.24, 62.40) | 0.013 | 0.00 (0.00, 0.00) | 0.019 | 0.00 (0.00, 5.79) | 0.064 | 0.00 (0.00, 129217.71) | 0.207 |
Arachidonic acid (20:4n6) | 0.17 (− 0.09, 0.43) | 0.196 | 0.74 (0.53, 1.03) | 0.072 | 0.79 (0.61, 1.03) | 0.084 | 0.94 (0.71, 1.23) | 0.644 |
Omega-6 PUFAs | 0.11 (− 0.09, 0.31) | 0.288 | 0.84 (0.65, 1.09) | 0.183 | 0.89 (0.74, 1.07) | 0.219 | 0.94 (0.78, 1.14) | 0.539 |
Omega-6/3 ratio | 0.10 (− 0.45, 0.65) | 0.723 | 1.16 (0.61, 2.19) | 0.657 | 1.39 (0.83, 2.33) | 0.205 | 1.29 (0.75, 2.23) | 0.361 |