Pouwer F, Nijpels G, Beekman A T, Dekker J M, van Dam R M, Heine R J, Snoek F J
Vrije Universiteit Medical Centre, Department of Medical Psychology, EMGO Institute, Amsterdam, the Netherlands.
Diabet Med. 2005 Nov;22(11):1465-75. doi: 10.1111/j.1464-5491.2005.01661.x.
Evidence strongly suggests that depression is a common complication of Type 2 diabetes mellitus. However, there is considerable room to improve the effectiveness of pharmacological antidepressant agents, as in only 50-60% of the depressed subjects with diabetes does pharmacotherapy lead to remission of depression. The aim of the present paper was to review whether polyunsaturated fatty acids (PUFA) of the omega-3 family could be used for the prevention and treatment of depression in Type 2 diabetes.
MEDLINE database and published reference lists were used to identify studies that examined the associations between omega-3 PUFA and depression. To examine potential side-effects, such as on glycaemic control, studies regarding the use of omega-3 supplements in Type 2 diabetes were also reviewed.
Epidemiological and clinical studies suggest that a high intake of omega-3 PUFA protects against the development of depression. There is also some evidence that a low intake of omega-3 is associated with an increased risk of Type 2 diabetes, but the results are less conclusive. Results from randomized controlled trials in non-diabetic subjects with major depression show that eicosapentaenoic acid is an effective adjunct treatment of depression in diabetes, while docosahexanoic acid is not. Moreover, consumption of omega-3 PUFA reduces the risk of cardiovascular disease and may therefore indirectly decrease depression in Type 2 diabetes, via the reduction of cardiovascular complications.
Supplementation with omega-3 PUFA, in particular eicosapentaenoic acid, may be a safe and helpful tool to reduce the incidence of depression and to treat depression in Type 2 diabetes. Further studies are now justified to test these hypotheses in patients with Type 2 diabetes.
有充分证据表明抑郁症是2型糖尿病的常见并发症。然而，提高抗抑郁药物疗效的空间仍很大，因为在患有糖尿病的抑郁症患者中，只有50% - 60%的患者通过药物治疗可使抑郁症缓解。本文旨在综述ω-3族多不饱和脂肪酸（PUFA）是否可用于预防和治疗2型糖尿病患者的抑郁症。
利用MEDLINE数据库和已发表文献的参考文献列表来识别研究ω-3多不饱和脂肪酸与抑郁症之间关联的研究。为了研究潜在的副作用，如对血糖控制的影响，还查阅了有关在2型糖尿病中使用ω-3补充剂的研究。
流行病学和临床研究表明，高摄入ω-3多不饱和脂肪酸可预防抑郁症的发生。也有一些证据表明，低摄入ω-3与2型糖尿病风险增加有关，但结果不太确凿。在患有重度抑郁症的非糖尿病受试者中进行的随机对照试验结果表明，二十碳五烯酸对糖尿病患者的抑郁症是一种有效的辅助治疗药物，而二十二碳六烯酸则不然。此外，摄入ω-3多不饱和脂肪酸可降低心血管疾病风险，因此可能通过减少心血管并发症间接降低2型糖尿病患者的抑郁症发生率。
补充ω-3多不饱和脂肪酸，尤其是二十碳五烯酸，可能是降低2型糖尿病患者抑郁症发病率和治疗抑郁症的一种安全且有效的方法。现在有必要进行进一步研究以在2型糖尿病患者中验证这些假设。
