Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease?
Background and aims: Breastfeeding is recognized as one of the most influential drivers of the gut microbiome. In turn, alterations in the gut microbiome may play a role in the development and severity of spondyloarthritis (SpA). We aimed to analyze different disease outcomes in patients with axial...
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/1863 |
| _version_ | 1797615001806045184 |
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| author | Sara Alonso Ignacio Braña Estefanía Pardo Stefanie Burger Pablo González del Pozo Mercedes Alperi Rubén Queiro |
| author_facet | Sara Alonso Ignacio Braña Estefanía Pardo Stefanie Burger Pablo González del Pozo Mercedes Alperi Rubén Queiro |
| author_sort | Sara Alonso |
| collection | DOAJ |
| description | Background and aims: Breastfeeding is recognized as one of the most influential drivers of the gut microbiome. In turn, alterations in the gut microbiome may play a role in the development and severity of spondyloarthritis (SpA). We aimed to analyze different disease outcomes in patients with axial SpA (axSpA) based on the history of breastfeeding. Patients and methods: A random sample was selected from a large database of axSpA patients. Patients were divided based on history of breastfeeding and several disease outcomes were compared. Both groups were also compared based on disease severity. Adjusted linear and logistic regression statistical methods were used. Results: The study included 105 patients (46 women and 59 men), and the median age was 45 years (IQR: 16–72), and the mean age at diagnosis was 34.3 ± 10.9 years. Sixty-one patients (58.1%) were breastfed, with a median duration of 4 (IQR: 1–24) months. After the fully adjusted model, BASDAI [−1.13 (95%CI: −2.04, −0.23), <i>p</i> = 0.015] and ASDAS [−0.38 (95%CI: −0.72, −0.04), <i>p</i> = 0.030] scores were significantly lower in breastfed patients. Forty-two percent had severe disease. In the adjusted logistic model for age, sex, disease duration, family history, HLA-B27, biologic therapy, smoking, and obesity, breastfeeding had a protective effect against the development of severe disease (OR 0.22, 95%CI: 0.08–0.57, <i>p</i> = 0.003). The selected sample size was sufficient to detect this difference with a statistical power of 87% and a confidence level of 95%. Conclusion: Breastfeeding might exert a protective effect against severe disease in patients with axSpA. These data need further confirmation. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:20:18Z |
| publishDate | 2023-02-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-1e93488f32734b929ea00f069a43b9d62023-11-17T07:59:22ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01125186310.3390/jcm12051863Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease?Sara Alonso0Ignacio Braña1Estefanía Pardo2Stefanie Burger3Pablo González del Pozo4Mercedes Alperi5Rubén Queiro6Rheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainRheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainRheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainRheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainRheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainRheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainRheumatology Service, Hospital Universitario Central de Asturias, 33011 Oviedo, SpainBackground and aims: Breastfeeding is recognized as one of the most influential drivers of the gut microbiome. In turn, alterations in the gut microbiome may play a role in the development and severity of spondyloarthritis (SpA). We aimed to analyze different disease outcomes in patients with axial SpA (axSpA) based on the history of breastfeeding. Patients and methods: A random sample was selected from a large database of axSpA patients. Patients were divided based on history of breastfeeding and several disease outcomes were compared. Both groups were also compared based on disease severity. Adjusted linear and logistic regression statistical methods were used. Results: The study included 105 patients (46 women and 59 men), and the median age was 45 years (IQR: 16–72), and the mean age at diagnosis was 34.3 ± 10.9 years. Sixty-one patients (58.1%) were breastfed, with a median duration of 4 (IQR: 1–24) months. After the fully adjusted model, BASDAI [−1.13 (95%CI: −2.04, −0.23), <i>p</i> = 0.015] and ASDAS [−0.38 (95%CI: −0.72, −0.04), <i>p</i> = 0.030] scores were significantly lower in breastfed patients. Forty-two percent had severe disease. In the adjusted logistic model for age, sex, disease duration, family history, HLA-B27, biologic therapy, smoking, and obesity, breastfeeding had a protective effect against the development of severe disease (OR 0.22, 95%CI: 0.08–0.57, <i>p</i> = 0.003). The selected sample size was sufficient to detect this difference with a statistical power of 87% and a confidence level of 95%. Conclusion: Breastfeeding might exert a protective effect against severe disease in patients with axSpA. These data need further confirmation.https://www.mdpi.com/2077-0383/12/5/1863axial spondyloarthritisbreastfeedingdisease activityquality of lifeprognosis |
| spellingShingle | Sara Alonso Ignacio Braña Estefanía Pardo Stefanie Burger Pablo González del Pozo Mercedes Alperi Rubén Queiro Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? Journal of Clinical Medicine axial spondyloarthritis breastfeeding disease activity quality of life prognosis |
| title | Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? |
| title_full | Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? |
| title_fullStr | Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? |
| title_full_unstemmed | Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? |
| title_short | Are Patients with Axial Spondyloarthritis Who Were Breastfed Protected against the Development of Severe Disease? |
| title_sort | are patients with axial spondyloarthritis who were breastfed protected against the development of severe disease |
| topic | axial spondyloarthritis breastfeeding disease activity quality of life prognosis |
| url | https://www.mdpi.com/2077-0383/12/5/1863 |
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