Yamashita Akihiro, Noguchi Hiroko, Hamazaki Kei, Sato Yasuhiro, Narisawa Tomomi, Kawashima Yuzuru, Usuki Masato, Nishi Daisuke, Yoshimasu Haruo, Horikawa Naoshi, Matsuoka Yutaka J
Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan; Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
School of Distance Learning, Musashino University, Tokyo, Japan.
J Affect Disord. 2017 Aug 15;218:306-312. doi: 10.1016/j.jad.2017.04.062. Epub 2017 May 3.
Around 20% of patients with acute coronary syndrome (ACS) develop depression. Furthermore, some observational studies revealed baseline polyunsaturated fatty acids (PUFAs) may affect the prognosis of depression after ACS. This prospective cohort study examined the association between psychiatric disorder and PUFAs after ACS.
Subjects were ACS patients admitted to a Tokyo teaching hospital. Psychiatric morbidity as a primary endpoint was measured using structured interview 3 months after admission. At admission, serum n-3 and n-6 PUFAs were measured by gas chromatography and patients were interviewed to evaluate medical information. Multiple logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals to examine the association between PUFAs at baseline and psychiatric disorder after ACS.
Between March 2014 and August 2016, 100 patients completed the follow-up assessment. Eleven patients (11%) showed some form of new-onset psychiatric disorder at 3 months, mainly depressive episode (major, 5; minor, 1) and PTSD (full, 1; partial, 2). Psychiatric disorder was predicted by serum linoleic acid level (OR=3.96) and Hospital Anxiety and Depression Scale total score (OR=1.34) at baseline. No significant associations were seen with other PUFAs.
The results were obtained from a single hospital and based on a small number of participants. There might be some patients with new-onset psychiatric disorder among the refused patients.
Psychiatric disorder incidence in ACS patients might be lower in Japan than in Western countries. Reduced intake of linoleic acid-containing foods might prevent depression or PTSD after ACS.
约20%的急性冠状动脉综合征（ACS）患者会出现抑郁。此外，一些观察性研究显示，基线多不饱和脂肪酸（PUFA）可能影响ACS后抑郁的预后。这项前瞻性队列研究调查了ACS后精神障碍与PUFA之间的关联。
研究对象为入住东京一家教学医院的ACS患者。入院3个月后，采用结构化访谈测量作为主要终点的精神疾病发病率。入院时，通过气相色谱法测量血清n-3和n-6多不饱和脂肪酸，并对患者进行访谈以评估医疗信息。进行多因素逻辑回归分析以计算优势比（OR）和95%置信区间，以检验基线时的PUFA与ACS后精神障碍之间的关联。
在2014年3月至2016年8月期间，100例患者完成了随访评估。11例患者（11%）在3个月时出现某种形式的新发精神障碍，主要为抑郁发作（重度，5例；轻度，1例）和创伤后应激障碍（完全型，1例；部分型，2例）。基线时血清亚油酸水平（OR=3.96）和医院焦虑抑郁量表总分（OR=1.34）可预测精神障碍。未发现与其他PUFA有显著关联。
结果来自一家医院，且基于少数参与者。拒绝参与的患者中可能有一些新发精神障碍患者。
日本ACS患者的精神障碍发病率可能低于西方国家。减少含亚油酸食物的摄入量可能预防ACS后的抑郁或创伤后应激障碍。
