Messamore Erik, Almeida Daniel M, Jandacek Ronald J, McNamara Robert K
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0516, USA; Lindner Center of HOPE, Mason, OH, USA.
Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45224, USA.
Prog Lipid Res. 2017 Apr;66:1-13. doi: 10.1016/j.plipres.2017.01.001. Epub 2017 Jan 6.
A body of evidence has implicated dietary deficiency in omega-3 polyunsaturated fatty acids (n-3 PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology and etiology of recurrent mood disorders including major depressive disorder (MDD) and bipolar disorder. Cross-national and cross-sectional evidence suggests that greater habitual intake of n-3 PUFA is associated with reduced risk for developing mood symptoms. Meta-analyses provide strong evidence that patients with mood disorders exhibit low blood n-3 PUFA levels which are associated with increased risk for the initial development of mood symptoms in response to inflammation. While the etiology of this n-3 PUFA deficit may be multifactorial, n-3 PUFA supplementation is sufficient to correct this deficit and may also have antidepressant effects. Rodent studies suggest that n-3 PUFA deficiency during perinatal development can recapitulate key neuropathological, neurochemical, and behavioral features associated with mood disorders. Clinical neuroimaging studies suggest that low n-3 PUFA biostatus is associated with abnormalities in cortical structure and function also observed in mood disorders. Collectively, these findings implicate dietary n-3 PUFA insufficiency, particularly during development, in the pathophysiology of mood dysregulation, and support implementation of routine screening for and treatment of n-3 PUFA deficiency in patients with mood disorders.
大量证据表明，饮食中缺乏ω-3多不饱和脂肪酸（n-3 PUFA），包括二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），与复发性情绪障碍（包括重度抑郁症（MDD）和双相情感障碍）的病理生理学和病因学有关。跨国和横断面证据表明，习惯性摄入更多的n-3 PUFA与情绪症状发生风险降低有关。荟萃分析提供了强有力的证据，表明情绪障碍患者血液中的n-3 PUFA水平较低，这与因炎症而首次出现情绪症状的风险增加有关。虽然这种n-3 PUFA缺乏的病因可能是多因素的，但补充n-3 PUFA足以纠正这种缺乏，并且可能还具有抗抑郁作用。啮齿动物研究表明，围产期发育期间n-3 PUFA缺乏可重现与情绪障碍相关的关键神经病理学、神经化学和行为特征。临床神经影像学研究表明，低n-3 PUFA生物状态与情绪障碍中也观察到的皮质结构和功能异常有关。总体而言，这些发现表明饮食中n-3 PUFA不足，尤其是在发育期间，与情绪调节障碍的病理生理学有关，并支持对情绪障碍患者进行n-3 PUFA缺乏的常规筛查和治疗。
