Wang Feifei, Yuan Hui, Jin Kun, Tang Hui, Guo Jimin, Wang Chuan-Yue, Chen Jindong, Dong Fang, Wang Lu
The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Front Nutr. 2024 Dec 12;11:1464526. doi: 10.3389/fnut.2024.1464526. eCollection 2024.
There is a close correlation between bone loss, depression, and antidepressants. N-3 PUFA supplementation has been considered an effective add-on therapeutic approach in ameliorating bone loss and relieving depression. However, the adjunctive effect of n-3 PUFA on bone metabolism in participants with depression is still unknown. This is a pilot study to investigate the dynamics of bone metabolism in depression and evaluate the efficacy of fish oil on bone loss in depression.
In this study, we focused on the change of bone turnover markers in depression, the effect of n-3 PUFA supplementation on bone turnover markers, and its association with clinical characteristics. A case-control study and a secondary analysis of a previously published randomized clinical trial (NCT03295708) that evaluates the efficacy of n-3 PUFA supplementation in venlafaxine-treated depressed participants have been included.
The levels of PINP (z = -2.233, = 0.026) in depressed participants were significantly increased compared with healthy controls at baseline. The secondary analysis has shown significant differences exited on CTX ( = 4.848, = 0.028) and OSTEOC ( = 6.178, = 0.013) between n-3 PUFA and placebo group. The levels of CTX and OSTEOC ( < 0.05) significantly decreased in the placebo group, which indicates that venlafaxine treatment reduces both bone formation and resorption markers. While the levels of OSTEOC and PINP were increased in the n-3 PUFA group ( < 0.05). Moreover, the change in bone turnover markers showed consistency with clinical symptomatic outcomes.
Participants with first-diagnosed, drug-naïve depression show active bone formation. Venlafaxine decreases bone remodeling, while n-3 PUFA increases bone formation, bringing light to preventing and treating bone loss in depression.
ClinicalTrials.gov, NCT03295708.
骨质流失、抑郁症和抗抑郁药之间存在密切关联。补充n-3多不饱和脂肪酸（PUFA）被认为是改善骨质流失和缓解抑郁的一种有效辅助治疗方法。然而，n-3 PUFA对抑郁症患者骨代谢的辅助作用仍不明确。这是一项初步研究，旨在调查抑郁症患者骨代谢的动态变化，并评估鱼油对抑郁症患者骨质流失的疗效。
在本研究中，我们重点关注抑郁症患者骨转换标志物的变化、补充n-3 PUFA对骨转换标志物的影响及其与临床特征的关联。纳入了一项病例对照研究以及对之前发表的一项随机临床试验（NCT03295708）的二次分析，该试验评估了在接受文拉法辛治疗的抑郁症患者中补充n-3 PUFA的疗效。
在基线时，与健康对照组相比，抑郁症患者的I型前胶原N端前肽（PINP）水平显著升高（z = -2.233，P = 0.026）。二次分析显示，n-3 PUFA组和安慰剂组在交联C端肽（CTX）（P = 4.848，P = 0.028）和骨钙素（OSTEOC）（P = 6.178，P = 0.013）方面存在显著差异。安慰剂组的CTX和OSTEOC水平显著降低（P < 0.05），这表明文拉法辛治疗可降低骨形成和骨吸收标志物。而在n-3 PUFA组中，OSTEOC和PINP水平升高（P < 0.05）。此外，骨转换标志物的变化与临床症状结果一致。
首次诊断、未接受过药物治疗的抑郁症患者表现出活跃的骨形成。文拉法辛可减少骨重塑，而n-3 PUFA可增加骨形成，为抑郁症患者骨质流失的防治带来了希望。
ClinicalTrials.gov，NCT03295708。
