Christian Lisa M, Young Andrea S, Mitchell Amanda M, Belury Martha A, Gracious Barbara L, Arnold L Eugene, Fristad Mary A
Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America.
The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America.
PLoS One. 2017 Apr 5;12(4):e0173087. doi: 10.1371/journal.pone.0173087. eCollection 2017.
Guidelines for suggested intake of ω-3 polyunsaturated fatty acids (PUFAs) are limited in youth and rely primarily on age. However, body weight varies considerably within age classifications. The current analyses examined effects of body weight and body mass index (BMI) on fatty acid accumulation in 64 youth (7-14 years) with a diagnosed mood disorder in a double-blind randomized-controlled trial (2000mg ω-3 supplements or a control capsule) across 12 weeks. Weight and height were measured at the first study visit and EPA and DHA levels were determined using fasting blood samples obtained at both the first and end-of-study visits. In the ω-3 supplementation group, higher baseline body weight predicted less plasma accumulation of both EPA [B = -0.047, (95% CI = -0.077; -0.017), β = -0.54, p = 0.003] and DHA [B = -0.02, (95% CI = -0.034; -0.007), β = -0.52, p = 0.004]. Similarly, higher BMI percentile as well as BMI category (underweight, normal weight, overweight/obese) predicted less accumulation of EPA and DHA (ps≤0.01). Adherence to supplementation was negatively correlated with BMI percentile [B = -0.002 (95% CI = -0.004; 0.00), β = -0.44, p = 0.019], but did not meaningfully affect observed associations. As intended, the control supplement exerted no significant effect on plasma levels of relevant fatty acids regardless of youth body parameters. These data show strong linear relationships of both absolute body weight and BMI percentile with ω-3 PUFA accumulation in youth. A dose-response effect was observed across the BMI spectrum. Given increasing variability in weight within BMI percentile ranges as youth age, dosing based on absolute weight should be considered. Moreover, effects of weight should be incorporated into statistical models in studies examining clinical effects of ω-3 PUFAs in youth as well as adults, as weight-related differences in effects may contribute meaningfully to inconsistencies in the current literature.
WHO International Clinical Trial Registry Platform NCT01341925 and NCT01507753.
关于ω-3多不饱和脂肪酸（PUFA）建议摄入量的指南在青少年群体中较为有限，且主要依据年龄制定。然而，在相同年龄分类中体重差异相当大。在一项为期12周的双盲随机对照试验（服用2000毫克ω-3补充剂或对照胶囊）中，对64名患有确诊情绪障碍的青少年（7至14岁）进行了分析，研究体重和体重指数（BMI）对脂肪酸积累的影响。在首次研究访视时测量体重和身高，并使用首次访视和研究结束时采集的空腹血样测定EPA和DHA水平。在ω-3补充剂组中，较高的基线体重预示着EPA[B = -0.047，（95%置信区间 = -0.077；-0.017），β = -0.54，p = 0.003]和DHA[B = -0.02，（95%置信区间 = -0.034；-0.007），β = -0.52，p = 0.004]在血浆中的积累量较少。同样，较高的BMI百分位数以及BMI类别（体重过轻、正常体重、超重/肥胖）预示着EPA和DHA的积累量较少（p值≤0.01）。补充剂的依从性与BMI百分位数呈负相关[B = -0.002（95%置信区间 = -0.004；0.00），β = -0.44，p = 0.019]，但对观察到的关联没有显著影响。正如预期的那样，无论青少年身体参数如何，对照补充剂对相关脂肪酸的血浆水平均无显著影响。这些数据表明，青少年的绝对体重和BMI百分位数与ω-3 PUFA积累之间存在很强的线性关系。在整个BMI范围内均观察到剂量反应效应。鉴于随着青少年年龄增长，BMI百分位数范围内体重的变异性增加，应考虑基于绝对体重给药。此外，在研究ω-3 PUFAs对青少年及成年人的临床影响时，体重的影响应纳入统计模型，因为与体重相关的效应差异可能对当前文献中的不一致性有重要贡献。
世界卫生组织国际临床试验注册平台NCT01341925和NCT01507753。
