Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Biol Psychiatry. 2010 Jul 15;68(2):140-7. doi: 10.1016/j.biopsych.2010.03.018. Epub 2010 May 10.
On the basis of evidence from studies showing the antidepressant effects of omega-3 polyunsaturated fatty acids and the inverse relation between fish consumption and the prevalence of depression, the phospholipid hypothesis seems promising in ascertaining the etiology and treatment of depression. Although several studies have shown lower levels of omega-3 (n-3) polyunsaturated fatty acids in depressive patients, the results of individual polyunsaturated fatty acids, including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and the omega-6 (n-6) polyunsaturated fatty acid arachidonic acid (AA), were inconsistent.
We conducted the meta-analyses of 14 studies comparing the levels of polyunsaturated fatty acids between depressive patients and control subjects. The effect size of each study was synthesized by using a random effects model.
Compared with control subjects, the levels of EPA, DHA, and total n-3 polyunsaturated fatty acids were significantly lower in depressive patients. There was no significant change in AA or total n-6 polyunsaturated fatty acids.
The results showed lower levels of EPA, DHA, and total n-3 polyunsaturated fatty acids in patients with depression, thus implying that n-3 polyunsaturated fatty acids play a role in the pathogenesis of depression. Our findings provide further support to the phospholipid hypothesis of depression and a rationale for using n-3 polyunsaturated fatty acids as an alternative treatment for depression. With these results, future studies examining specific roles of DHA and EPA in different clusters of depressive symptoms are warranted.
基于研究显示ω-3 多不饱和脂肪酸具有抗抑郁作用，以及鱼类摄入量与抑郁发生率呈反比的证据，磷脂假说似乎有望确定抑郁的病因和治疗方法。尽管几项研究表明抑郁患者体内 ω-3（n-3）多不饱和脂肪酸水平较低，但个别多不饱和脂肪酸（包括二十二碳六烯酸（DHA）、二十碳五烯酸（EPA）和 ω-6（n-6）多不饱和脂肪酸花生四烯酸（AA））的结果并不一致。
我们对 14 项比较抑郁患者和对照组多不饱和脂肪酸水平的研究进行了荟萃分析。使用随机效应模型综合每个研究的效应大小。
与对照组相比，抑郁患者体内 EPA、DHA 和总 n-3 多不饱和脂肪酸水平显著降低。AA 或总 n-6 多不饱和脂肪酸没有明显变化。
研究结果表明，抑郁患者体内 EPA、DHA 和总 n-3 多不饱和脂肪酸水平较低，提示 n-3 多不饱和脂肪酸在抑郁发病机制中起作用。我们的研究结果进一步支持了抑郁的磷脂假说，并为使用 n-3 多不饱和脂肪酸作为抑郁的替代治疗提供了依据。鉴于这些结果，未来研究需要进一步研究 DHA 和 EPA 在不同抑郁症状群中的具体作用。
