School of Psychology, Queen's University, Belfast, UK.
Am J Clin Nutr. 2010 Mar;91(3):757-70. doi: 10.3945/ajcn.2009.28313. Epub 2010 Feb 3.
The debate over a role for n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) in depressed mood continues.
The objective was to update a previous systematic review and meta-analysis of published randomized controlled trials investigating the effects of n-3 PUFAs on depressed mood and to explore potential sources of heterogeneity.
Eight databases were searched for trials that randomly assigned participants to receive n-3 PUFAs/fish, measured depressed mood, used human participants, and included a comparison group up to April 2009.
Thirty-five randomized controlled trials were identified; 17 were not included in the previous review. The pooled standardized difference in mean outcome of the 29 trials that provided data to allow pooling (fixed-effects model) was 0.10 SD (95% CI: 0.02, 0.17) in those who received n-3 PUFAs compared with placebo, with strong evidence of heterogeneity (I(2) = 65%, P < 0.01). The presence of funnel plot asymmetry suggested that publication bias was a likely source of this heterogeneity. Depressive symptom severity and participant diagnosis also explained some of the observed heterogeneity. Greater effects of n-3 PUFAs were found in individuals with more-severe depressive symptoms. In trials that enrolled individuals with a diagnosed depressive disorder, the combined mean difference was 0.41 (95% CI: 0.26, 0.55), although evidence of heterogeneity was also found (I(2) = 71%). In trials that enrolled individuals without a depressive diagnosis, no beneficial effects of n-3 PUFAs were found (largest combined mean difference: 0.22; 95% CI: -0.01, 0.44; I(2) = 0%).
Trial evidence of the effects of n-3 PUFAs on depressed mood has increased but remains difficult to summarize because of considerable heterogeneity. The evidence available provides some support of a benefit of n-3 PUFAs in individuals with diagnosed depressive illness but no evidence of any benefit in individuals without a diagnosis of depressive illness.
关于 n-3 长链多不饱和脂肪酸（n-3PUFAs）在抑郁情绪中的作用，一直存在争议。
本研究旨在更新之前关于 n-3PUFAs 对抑郁情绪影响的系统评价和荟萃分析，并探讨潜在的异质性来源。
在 2009 年 4 月之前，我们检索了 8 个数据库，以查找将参与者随机分配接受 n-3PUFAs/鱼、测量抑郁情绪、使用人类参与者并包括对照组的试验。
确定了 35 项随机对照试验；其中 17 项未纳入之前的综述。29 项提供可用于汇总数据的试验（固定效应模型）的标准化均数差值的合并结果为 0.10 标准差（95%置信区间：0.02，0.17），存在明显的异质性（I2=65%，P<0.01）。漏斗图的不对称表明，发表偏倚可能是这种异质性的一个来源。抑郁症状严重程度和参与者诊断也解释了部分观察到的异质性。在抑郁症状较重的个体中，n-3PUFAs 的效果更大。在纳入已确诊抑郁症患者的试验中，联合平均差异为 0.41（95%置信区间：0.26，0.55），尽管也发现了异质性的证据（I2=71%）。在纳入未诊断为抑郁症的个体的试验中，未发现 n-3PUFAs 的有益效果（最大联合平均差异：0.22；95%置信区间：-0.01，0.44；I2=0%）。
关于 n-3PUFAs 对抑郁情绪影响的试验证据有所增加，但由于存在很大的异质性，仍然难以进行总结。现有证据为 n-3PUFAs 对诊断为抑郁症的个体有益提供了一些支持，但对没有抑郁症诊断的个体没有任何益处的证据。
