Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan; Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Brain Behav Immun. 2020 Mar;85:29-34. doi: 10.1016/j.bbi.2019.02.014. Epub 2019 Feb 15.
Omega-3 polyunsaturated fatty acids (PUFAs) reduce depressive symptoms through an anti-inflammatory effect, and injection of both omega-3 PUFAs and estradiol (E2) induces antidepressant-like effects in rats by regulating the expression of inflammatory cytokines. The aims of this study were to examine the association of increased E2 during pregnancy with depressive symptoms and with inflammatory cytokines in women who were and were not supplemented with omega-3 PUFAs.
Pregnant women with Edinburgh Postnatal Depression Scale scores ≥9 were recruited at 12-24 weeks of gestation. The participants were randomly assigned to receive 1800 mg omega-3 fatty acids (containing 1206 mg eicosapentaenoic acid [EPA]) or placebo for 12 weeks. E2, omega-3 PUFAs, high-sensitivity C-reactive protein, interleukin-6, and adiponectin were measured at baseline and at the 12-week follow-up. Multivariable regression analyses were conducted to examine the association of the changes of E2 and omega-3 PUFAs with the changes in depressive symptoms and with the changes of inflammatory cytokines at follow-up by intervention group.
Of the 108 participants in the trial, 100 (92.6%) completed the follow-up assessment including blood sampling. Multivariable regression analyses revealed that the increase of EPA and E2 was significantly associated with a decrease in depressive symptoms among the participants assigned to the omega-3 group, but not among those assigned to the placebo group. Neither E2 nor any PUFAs were associated with a change in inflammatory cytokines.
Supplementation with EPA and increased levels of E2 during pregnancy might function together to alleviate antenatal depression through a mechanism other than anti-inflammation.
ω-3 多不饱和脂肪酸（PUFAs）通过抗炎作用减轻抑郁症状，而ω-3 PUFAs 和雌二醇（E2）的联合注射通过调节炎症细胞因子的表达在大鼠中诱导抗抑郁作用。本研究旨在探讨妊娠期间 E2 水平升高与抑郁症状的关系，以及与接受或不接受ω-3 PUFAs 补充的女性的炎症细胞因子的关系。
在妊娠 12-24 周时，招募 Edinburgh 产后抑郁量表评分≥9 的孕妇。参与者被随机分配接受 1800mg ω-3 脂肪酸（含 1206mg 二十碳五烯酸 [EPA]）或安慰剂治疗 12 周。在基线和 12 周随访时测量 E2、ω-3 PUFAs、高敏 C 反应蛋白、白细胞介素 6 和脂联素。通过干预组进行多变量回归分析，以探讨 E2 和 ω-3 PUFAs 的变化与随访时抑郁症状的变化以及炎症细胞因子的变化之间的关系。
在参加试验的 108 名参与者中，有 100 名（92.6%）完成了包括血液采样的随访评估。多变量回归分析显示，在接受 ω-3 组治疗的参与者中，EPA 和 E2 的增加与抑郁症状的减轻显著相关，而在接受安慰剂组的参与者中则没有这种相关性。E2 或任何 PUFAs 均与炎症细胞因子的变化无关。
在妊娠期间补充 EPA 和增加 E2 水平可能通过一种非抗炎机制共同发挥作用，缓解产前抑郁。
