UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
J Affect Disord. 2019 Feb 15;245:1052-1060. doi: 10.1016/j.jad.2018.11.046. Epub 2018 Nov 6.
Recent evidence suggests that pro-inflammatory states may be independently associated with the risk of suicidality, above and beyond depression. This study assesses whether four indicators of inflammation, circulating levels of C-reactive protein (CRP), white blood cell (WBC) count and immunoglobulin E (IgE), and dietary inflammatory potential, measured using the Dietary Inflammatory Index® (DII), distinguish suicidal ideation (SI) from major depression (MD).
Data come from multiple cycles of the US National Health and Nutrition Examination Survey (N= 13,912; N= 17,076; N= 4,060). MD was measured using the Patient Health Questionnaire-9 (PHQ-9); SI was indicated by the last item of the PHQ-9. To assess SI independent from MD, participants were classified into four categories: SI with MD, SI without MD, MD without SI, and neither MD nor SI. Regression models were used to assess the relationship between indicators of inflammation and SI with and without MD.
None of the inflammatory indicators were able to distinguish SI status among MD cases. DII was associated with SI among individuals without MD. CRP, DII, and WBC were associated with MD. No associations were found for IgE.
Cross-section data prevent drawing causal conclusions. Underreporting of MD and suicidal ideation and measurement of habitual diet using 24 h dietary recalls are also weaknesses.
Dietary inflammatory potential was associated with suicide ideation among US adults with and without depression. Diet may play a role in suicide ideation and more empirical evidence is needed to determine whether nutritional protocols could aid in the treatment of suicidal behaviors. Findings did not support inflammatory factors having a relationship with suicide ideation distinct from depression.
最近的证据表明，促炎状态可能与自杀风险独立相关，超出了抑郁的影响。本研究评估了四种炎症指标，即循环 C 反应蛋白（CRP）、白细胞（WBC）计数和免疫球蛋白 E（IgE）水平，以及使用饮食炎症指数（DII）衡量的饮食炎症潜能，是否可以区分自杀意念（SI）和重度抑郁症（MD）。
数据来自美国国家健康和营养检查调查（N=13912；N=17076；N=4060）的多个周期。使用患者健康问卷-9（PHQ-9）测量 MD；PHQ-9 的最后一项表示 SI。为了评估 SI 与 MD 无关的情况，将参与者分为四类：有 MD 的 SI、无 MD 的 SI、无 MD 也无 SI、以及既无 MD 也无 SI。回归模型用于评估炎症指标与有和无 MD 的 SI 之间的关系。
在 MD 病例中，没有一种炎症指标能够区分 SI 状态。DII 与无 MD 的个体中的 SI 相关。CRP、DII 和 WBC 与 MD 相关。IgE 与 MD 无关。
横断面数据无法得出因果关系的结论。MD 和自杀意念的报告不足以及使用 24 小时膳食回忆法测量习惯性饮食也是研究的弱点。
饮食炎症潜能与美国有或无抑郁的成年人的自杀意念有关。饮食可能在自杀意念中起作用，需要更多的实证证据来确定营养方案是否有助于治疗自杀行为。研究结果不支持炎症因素与抑郁无关的自杀意念之间存在关系。
