Association of the energy-adjusted dietary inflammatory index and Sjögren's syndrome: a cross-sectional study

There are no studies in the literature examining the inflammatory content and effects of the diets of patients with primary Sjögren’s syndrome (PSS). This study aimed to investigate the relationship between the Energy-Adjusted Dietary Inflammatory Index (E-DII) and anthropometric measurements, disease activity, inflammatory markers, and blood lipid concentrations in female patients with PSS. A cross-sectional study was conducted between November 2020 and November 2021, including 102 female patients with a confirmed diagnosis of PSS. Dietary intake was assessed using the multiple-pass, 3-day food record method to calculate E-DII scores. Physical activity was evaluated using the International Physical Activity Questionnaire (Short Form), anthropometric measurements were taken, and the European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index (ESSDAI) was used to determine disease activity. Lipid profile and inflammatory markers were analyzed in blood samples. Patients had a median E-DII value of –2·36. An anti-inflammatory diet was associated with lower anthropometric measurements and reduced total cholesterol, triglycerides, and low-density lipoprotein cholesterol concentrations. Logistic regression analysis revealed a significant association between E-DII and complement C3 (OR: 1·03, 95 % CI: 1·00, 1·05, P = 0·021) and C4 (OR: 1·08, 95 % CI: 1·01, 1·13, P = 0·019) after adjusting for age, disease score, drug use for SS, smoking, and physical activity. However, no significant correlation was found between E-DII and ESSDAI scores, C-reactive protein, or erythrocyte sedimentation rate. In conclusion, a pro-inflammatory diet was associated with higher anthropometric measurements and adverse lipid profiles in PSS patients, but its relationship with disease activity and inflammation remains unclear.