Thesing C S, Lok A, Milaneschi Y, Assies J, Bockting C L H, Figueroa C A, Giltay E J, Penninx B W J H, Ruhé H G, Schene A H, Bot M, Mocking R J T
Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Academisch Medisch Centrum, University of Amsterdam, Amsterdam, The Netherlands.
Acta Psychiatr Scand. 2020 Apr;141(4):362-373. doi: 10.1111/acps.13136. Epub 2019 Dec 26.
Omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acid (PUFA) alterations in patients with major depressive disorder (MDD) have been shown to persist after remission. Whether these alterations are risk factors for MDD recurrence remains unknown. Here, we examined whether fatty acids predict time until MDD recurrence in remitted MDD patients.
Data were used from remitted MDD patients of the Netherlands Study of Depression and Anxiety (n = 356) and the Depression Evaluation Longitudinal Therapy Assessment studies (n = 118). Associations of FAs with time until MDD recurrence up to 8-year follow-up were analyzed using Cox regression analyses. Study-specific estimates were pooled using mega- and meta-analysis techniques.
27.5% (NESDA) and 56.8% (DELTA) participants had an MDD recurrence. Pooled results showed that no FA was significantly associated with time until MDD recurrence (n-3 PUFAs: hazard ratio (HR) = 1.17, 95% confidence interval (CI) = 0.98-1.41, P = 0.082; n-6 PUFAs: HR = 1.08, 95% CI = 0.84-1.38, P = 0.55).
In remitted MDD patients, circulating PUFAs were not associated with prospective risk of MDD recurrence. Consequently, circulating PUFAs are unlikely to reflect a vulnerability marker for recurrence, so correcting n-3 PUFA 'deficits' through supplementation does not seem a promising option to prevent MDD recurrence.
重度抑郁症(MDD)患者体内的ω-3(n-3)和ω-6(n-6)多不饱和脂肪酸(PUFA)变化在缓解后仍会持续存在。这些变化是否为MDD复发的危险因素尚不清楚。在此,我们研究了脂肪酸是否能预测缓解期MDD患者的MDD复发时间。
数据来自荷兰抑郁与焦虑研究(n = 356)和抑郁评估纵向治疗评估研究(n = 118)中的缓解期MDD患者。使用Cox回归分析来分析脂肪酸与长达8年随访期内MDD复发时间的关联。采用汇总分析和荟萃分析技术对各研究的估计值进行合并。
27.5%(荷兰抑郁与焦虑研究)和56.8%(抑郁评估纵向治疗评估研究)的参与者出现了MDD复发。汇总结果显示,没有脂肪酸与MDD复发时间显著相关(n-3多不饱和脂肪酸:风险比(HR)= 1.17,95%置信区间(CI)= 0.98 - 1.41,P = 0.082;n-6多不饱和脂肪酸:HR = 1.08,95% CI = 0.84 - 1.38,P = 0.55)。
在缓解期MDD患者中,循环多不饱和脂肪酸与MDD复发的前瞻性风险无关。因此,循环多不饱和脂肪酸不太可能反映复发的易感性标志物,所以通过补充来纠正n-3多不饱和脂肪酸“缺乏”似乎不是预防MDD复发的有效选择。