伴有焦虑障碍的重性抑郁障碍患者的ω-3 多不饱和脂肪酸（PUFA）状况。
Omega-3 polyunsaturated fatty acid (PUFA) status in major depressive disorder with comorbid anxiety disorders.
机构信息
Institute of Human Nutrition, Columbia University, New York, New York, USA.
出版信息
J Clin Psychiatry. 2013 Jul;74(7):732-8. doi: 10.4088/JCP.12m07970.
BACKGROUND
Although lower levels of omega-3 polyunsaturated fatty acids (PUFAs) are found in major depressive disorder, less is known about PUFA status and anxiety disorders.
METHOD
Medication-free participants with DSM-IV-defined major depressive disorder (MDD), with (n = 18) and without (n = 41) comorbid DSM-IV anxiety disorders, and healthy volunteers (n = 62) were recruited from October 2006 to May 2010 for mood disorder studies at the New York State Psychiatric Institute. Participants were 18-73 years of age (mean age, 35.8 ± 12.6 years). Depression and anxiety severity was assessed using depression and anxiety subscales from the 17-item Hamilton Depression Rating Scale. Plasma PUFAs eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) and the ratio of arachidonic acid (AA; 22:4n-6) to EPA (AA:EPA) were quantified. This secondary analysis employed analysis of variance with a priori planned contrasts to test for diagnostic group differences in log-transformed PUFA levels (logDHA, logEPA, and logAA:EPA).
RESULTS
Plasma levels of logDHA (F(2,118) = 4.923, P = .009), logEPA (F(2,118) = 6.442, P = .002), and logAA:EPA (F(2,118) = 3.806, P = .025) differed across groups. Participants with MDD had lower logDHA (t(118) = 2.324, P = .022) and logEPA (t(118) = 3.175, P = .002) levels and higher logAA:EPA levels (t(118) = -2.099, P = .038) compared with healthy volunteers. Lower logDHA (t(118) = 2.692, P = .008) and logEPA (t(118) = 2.524, P = .013) levels and higher logAA:EPA levels (t(118) = -2.322, P = .022) distinguished anxious from nonanxious MDD. Depression severity was not associated with PUFA plasma levels; however, anxiety severity across the entire sample correlated negatively with logDHA (r(p) = -0.22, P = .015) and logEPA (r(p) = -0.25, P = .005) levels and positively with logAA:EPA levels (r(p) = 0.18, P = .043).
CONCLUSIONS
The presence and severity of comorbid anxiety were associated with the lowest EPA and DHA levels. Further studies are needed to elucidate whether omega-3 PUFA supplementation may preferentially alleviate MDD with more severe anxiety.
背景
尽管在重度抑郁症中发现了较低水平的ω-3 多不饱和脂肪酸（PUFA），但关于 PUFA 状况和焦虑症的研究却较少。
方法
2006 年 10 月至 2010 年 5 月，从纽约州精神病学研究所的情绪障碍研究中招募了符合 DSM-IV 定义的重度抑郁症（MDD）、伴有（n=18）和不伴有（n=41）DSM-IV 焦虑症的无药物治疗参与者以及健康志愿者（n=62）。参与者年龄在 18-73 岁之间（平均年龄，35.8±12.6 岁）。使用 17 项汉密尔顿抑郁评定量表的抑郁和焦虑分量表评估抑郁和焦虑严重程度。量化了血浆多不饱和脂肪酸二十碳五烯酸（EPA；20:5n-3）和二十二碳六烯酸（DHA；22:6n-3）以及花生四烯酸（AA；22:4n-6）与 EPA（AA：EPA）的比值。该二次分析采用方差分析和事先计划的对比，以测试 log 转换的 PUFA 水平（logDHA、logEPA 和 logAA：EPA）在诊断组之间的差异。
结果
logDHA（F（2，118）=4.923，P=0.009）、logEPA（F（2，118）=6.442，P=0.002）和 logAA：EPA（F（2，118）=3.806，P=0.025）在组间存在差异。患有 MDD 的参与者 logDHA（t（118）=2.324，P=0.022）和 logEPA（t（118）=3.175，P=0.002）水平较低，logAA：EPA 水平较高（t（118）=-2.099，P=0.038）与健康志愿者相比。较低的 logDHA（t（118）=2.692，P=0.008）和 logEPA（t（118）=2.524，P=0.013）水平和较高的 logAA：EPA 水平（t（118）=-2.322，P=0.022）区分了焦虑性和非焦虑性 MDD。抑郁严重程度与 PUFA 血浆水平无关；然而，整个样本的焦虑严重程度与 logDHA（r（p）=-0.22，P=0.015）和 logEPA（r（p）=-0.25，P=0.005）水平呈负相关，与 logAA：EPA 水平呈正相关（r（p）=0.18，P=0.043）。
结论
伴发焦虑症的存在和严重程度与 EPA 和 DHA 水平最低有关。需要进一步研究阐明ω-3 多不饱和脂肪酸补充是否可以优先缓解焦虑程度更严重的 MDD。
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