Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan; Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Affect Disord. 2018 Sep;237:73-79. doi: 10.1016/j.jad.2018.05.004. Epub 2018 May 14.
Epidemiological evidence suggests that fish consumption and intake of n-3 polyunsaturated fatty acids (PUFA)-namely, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)-confer protection against depression. However, few studies have addressed the influence of the balance between n-3 PUFA and n-6 PUFA in the human body on depression.
A total of 2,529 community-dwelling Japanese residents aged ≥ 40 years were assessed for depressive symptoms (defined as a score of 16 points or more on the Center for Epidemiologic Studies Depression Scale [CES-D]) in 2007. The serum arachidonic acid (AA) /EPA ratio and AA/DHA ratio were measured in frozen samples collected in 2002 and categorized into quartiles. The odds ratios (ORs) for the presence of depressive symptoms were calculated using a logistic regression model.
The prevalence of depressive symptoms was 4.3%. There was no significant association between either the serum AA/EPA ratio or AA/DHA ratio and the presence of depressive symptoms. However, subjects with the highest serum AA/EPA ratios (range: 3.28-13.3) had a 4.10 times (95%CI: 1.13-19.80) greater OR for the presence of depressive symptoms than those with the lowest ratios (0.30-1.65) after adjusting for confounding factors in the subgroup with high-sensitivity C-reactive protein (hs-CRP) ≥ 1.0 mg/L, while no clear association was observed in the subgroup with hs-CRP < 1.0 mg/L.
Reverse causality is possible due to the cross-sectional study design.
Our findings suggest that a higher serum AA/EPA ratio is associated with a greater likelihood of depressive symptoms in subjects with systemic inflammation in the general Japanese population.
流行病学证据表明，食用鱼类和摄入 n-3 多不饱和脂肪酸（PUFA）——即二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）——可预防抑郁症。然而，很少有研究关注人体内 n-3 PUFA 与 n-6 PUFA 的平衡对抑郁症的影响。
2007 年，对 2529 名居住在社区的年龄≥40 岁的日本居民进行了抑郁症状评估（定义为流行病学研究中心抑郁量表[CES-D]得分为 16 分或以上）。在 2002 年采集的冷冻样本中测量了花生四烯酸（AA）/EPA 比值和 AA/DHA 比值，并将其分为四分位组。使用逻辑回归模型计算存在抑郁症状的优势比（OR）。
抑郁症状的患病率为 4.3%。血清 AA/EPA 比值或 AA/DHA 比值与抑郁症状的存在均无显著相关性。然而，在 hs-CRP≥1.0mg/L 的亚组中，血清 AA/EPA 比值最高（范围：3.28-13.3）的受试者出现抑郁症状的 OR 为 4.10（95%CI：1.13-19.80），明显高于比值最低（0.30-1.65）的受试者，而在 hs-CRP<1.0mg/L 的亚组中，没有明显的相关性。
由于研究设计为横断面研究，可能存在反向因果关系。
我们的研究结果表明，在一般日本人群中，全身炎症患者血清 AA/EPA 比值较高与出现抑郁症状的可能性更大相关。
