长链omega-3多不饱和脂肪酸对减轻成人焦虑和/或抑郁的作用随机对照试验的系统回顾和荟萃分析

IF 3
Christos F. Kelaiditis , E.Leigh Gibson , Simon C. Dyall
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引用次数: 0

摘要

ω-3多不饱和脂肪酸(PUFA)二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)和二十碳五油酸(DPAn-3)是降低焦虑和抑郁症状严重程度的有前景的治疗选择。然而,随机对照试验的荟萃分析得出了喜忧参半的结果。这项系统综述和荟萃分析回顾了证据,并评估了EPA、DHA和DPAn-3在降低焦虑和抑郁严重程度方面的疗效,特别考虑了该领域特有的方法学并发症,如ω-3多不饱和脂肪酸的剂量和比例以及安慰剂组分。对10项随机对照试验(包括1426名参与者)进行的随机效应荟萃分析显示,富含EPA的干预措施占EPA+DHA总量的比例≥60%(SMD:-0.36;95%CI:-0.68,-0.05;p=0.02)(I2=86%),且EPA剂量≥1g/天且<;2 g/天(SMD:-0.43;95%可信区间-0.79,-0.07;p=0.02)(I2=88%);然而,EPA剂量≥2 g/天与显著的治疗效果无关(SMD:-0.20;95%可信区间:-0.48.0.07;p=0.14)。只有一项研究报告称,EPA剂量为2.1 g/天(占EPA+DHA总量的85.6%),焦虑严重程度显著降低,因此不可能进行荟萃分析。没有发现服用DPAn-3的试验。漏斗图的视觉检查显示不对称性,表明试验之间存在发表偏倚和异质性。这些结果支持EPA在抑郁症中的治疗潜力,其比例≥EPA+DHA总量的60%,剂量≥1g/天,<;2克/天。观察到的发表偏倚和试验之间的异质性反映出,考虑到ω-3多不饱和脂肪酸研究的独特性质,需要在该领域进行更高质量的试验,以更充分地阐明EPA、DHA和DPAn-3的治疗潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of long-chain omega-3 polyunsaturated fatty acids on reducing anxiety and/or depression in adults; A systematic review and meta-analysis of randomised controlled trials

The omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic- (EPA), docosahexaenoic- (DHA) and docosapentaenoic acid (DPAn-3) are promising therapeutic options in reducing the severity of anxious and depressive symptoms. However, meta-analyses of randomised controlled trials (RCTs) yield mixed findings. This systematic review and meta-analysis reviewed the evidence and assessed the efficacy of EPA, DHA and DPAn-3 in reducing the severity of anxiety and depression with specific consideration to methodological complications unique to the field e.g., dose and ratio of omega-3 PUFAs and placebo composition. Random-effects meta-analysis of ten RCTs comprising 1426 participants revealed statistically significant reduction in depression severity with EPA-enriched interventions at proportions ≥ 60% of total EPA + DHA (SMD: -0.36; 95% CI: -0.68, -0.05; p = 0.02) (I2 = 86%) and EPA doses between ≥ 1 g/day and < 2 g/day (SMD: -0.43; 95% CI: -0.79, -0.07; p = 0.02) (I2 = 88%); however, EPA doses ≥ 2 g/day were not associated with significant therapeutic effects (SMD: -0.20; 95% CI: -0.48, 0.07; p = 0.14). Only one study reported significant reduction in anxiety severity with 2.1 g/day EPA (85.6% of total EPA + DHA), therefore meta-analysis was not possible. No trials administering DPAn-3 were identified. Visual examination of the funnel plot revealed asymmetry, suggesting publication bias and heterogeneity amongst the trials. These results support the therapeutic potential of EPA in depression at proportions ≥ 60% of total EPA + DHA and doses ≥ 1 g/day and < 2 g/day. The observed publication bias and heterogeneity amongst the trials reflect the need for more high-quality trials in this area with consideration to the unique nature of omega-3 PUFAs research, to more fully elucidate the therapeutic potential of EPA, DHA and DPAn-3.

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来源期刊
Prostaglandins, leukotrienes, and essential fatty acids
Prostaglandins, leukotrienes, and essential fatty acids Clinical Biochemistry, Endocrinology, Diabetes and Metabolism
CiteScore
5.30
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0.00%
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审稿时长
64 days
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