MaSc Medicine at University Medical Center Utrecht (UMCU), Utrecht, the Netherlands.
Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
Nutr Neurosci. 2021 Apr;24(4):279-295. doi: 10.1080/1028415X.2019.1625222. Epub 2019 Aug 9.
Nutrient and genetic biomarkers in nutraceutical trials may allow for the personalisation of nutraceutical treatment and assist in predicting treatment response. We aimed to synthesise the findings of trials which have included these biomarkers to determine which may be most useful for predicting nutraceutical response in mood and psychotic disorders. A systematic review was conducted assessing available literature concerning nutraceutical clinical trials in mood and psychotic disorders (major depression, bipolar disorder, schizophrenia) with baseline and endpoint blood nutrient markers or genetic data available. We identified 35 eligible studies (total = 3836 participants) examining baseline and endpoint nutrient biomarkers and/or genetic polymorphisms. The key result, as reported in 10 out of 11 omega-3 studies, was a strong association between polyunsaturated fatty acid concentrations (mostly EPA and DHA) and psychiatric outcomes, although the exact nature of the association varied between studies and diagnoses. There was no consistent evidence for levels of other nutrients (including Vitamin D, SAM/SAH ratios, carnitine, folate and vitamin B12) relating to treatment response. The evidence for associations between one-carbon cycle genotypes (e.g. MTHFR C677 T, MTR and FOLH1) and treatment response was also inconsistent. The available data tentatively supports omega-3 indices as biomarkers of response to omega-3 treatments in mood disorders. Further research with larger samples examining combinations of polymorphisms is required to determine if any genetic factors influence nutraceutical response in mood and psychotic disorders.
营养和遗传生物标志物可用于营养疗法的个体化，并有助于预测治疗反应。我们旨在综合具有这些生物标志物的试验结果，以确定哪些标志物最有助于预测情绪和精神病性障碍中的营养疗法反应。系统评价评估了有关情绪和精神病性障碍（重度抑郁症、双相情感障碍、精神分裂症）中营养疗法临床试验的现有文献，这些试验具有基线和终点血液营养标志物或遗传数据。我们确定了 35 项符合条件的研究（共 3836 名参与者），这些研究检查了基线和终点的营养生物标志物和/或遗传多态性。11 项 omega-3 研究中的 10 项报告了主要结果，即多不饱和脂肪酸浓度（主要是 EPA 和 DHA）与精神科结果之间存在很强的关联，尽管研究和诊断之间的关联的确切性质有所不同。没有一致的证据表明其他营养素（包括维生素 D、SAM/SAH 比值、肉碱、叶酸和维生素 B12）的水平与治疗反应有关。与单碳循环基因型（例如 MTHFR C677T、MTR 和 FOLH1）之间关联的证据也不一致。现有数据初步支持 omega-3 指数作为情绪障碍中 omega-3 治疗反应的生物标志物。需要进一步研究更大的样本，以检查多态性的组合，以确定任何遗传因素是否会影响情绪和精神病性障碍中的营养疗法反应。
