Polyunsaturated fatty acids moderate the effect of poor sleep on depression risk. (March 2016)

• Record Type: Journal Article
• Authors: Lotrich, Francis E.; Sears, Barry; McNamara, Robert K.
• Is Part Of: Prostaglandins, leukotrienes, and essential fatty acids. Volume 106(2016:Mar.)
• Page Start: 19
• Page End: 25
• Publication Date: 2016-03
• Subjects: (ALA) Alpha-linolenic acid -- (AA) Arachidonic acid -- (BDI) Beck Depression Inventory -- (DGLA) Dihomo-gamma-linolenic acid -- (DHA) Docosahexaenoic acid -- (EPA) Eicosapentaenoic acid -- (FAME) Fatty acid methyl ester -- (GLA) Gamma-linolenic acid -- (IFN-α) Interferon-alpha -- (IFN-MDD) Interferon-alpha-associated depression -- (LES) Life events scale -- (LA) Linoleic acid -- (LCn-3) Long chain omega-3 -- (MDD) Major depressive disorder -- (MADRS) Montgomery–Asberg Depression Rating Scale -- (PSS) Perceived Stress Scale -- (PSQI) Pittsburgh Sleep Quality Inventory -- (PUFA) Polyunsaturated fatty acid -- (ROC) Receiver operator curve -- (SSRI) Selective serotonin reuptake inhibitor -- (SCID-IV) Structured Clinical Interview of DSM-IV; Polyunsaturated fatty acids -- Docosahexaenoic acid -- Eicosapentaenoic acid -- Arachidonic acid -- Interferon-alpha -- Sleep quality; Lipids -- Periodicals; Unsaturated fatty acids -- Periodicals; Prostaglandins -- Periodicals; Leukotrienes -- Periodicals; Fatty Acids, Unsaturated -- Periodicals; Acides gras insaturés -- Périodiques; Prostaglandines -- Périodiques; Leucotriènes -- Périodiques; Lipides -- Périodiques; 612.01577
• DOI: 10.1016/j.plefa.2015.10.004
• Languages: English
• ISSNs: 0952-3278

Abstract

Abstract: Although potentially modifiable risk factors for interferon-alpha (IFN-α)-associated depression (IFN-MDD) have been identified, it is not currently known how they interact to confer risk. In the present study we prospectively investigated interactions among poor sleep quality, high-stress, pre-existing depressive symptoms, and polyunsaturated fatty acid status. Non-depressed hepatitis C patients ( n =104) were followed prospectively during IFN-α therapy. IFN-MDD occurs in 20–40% of patients and was diagnosed using the Structured Clinical Interview of DSM-IV (SCID-IV), with incidence examined using Cox regression. Baseline Pittsburgh Sleep Quality Inventory (PSQI), Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), and a range of plasma long-chain fatty acid levels were measured (gas chromatography) – focusing on the ratio of arachidonic acid (AA) to docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) (AA/EPA+DHA). The AA/EPA+DHA ratio ( Β =0.40±0.16; p =0.006), PSQI ( Β =0.12±0.04; p =0.001), PSS ( Β =0.07±0.02; p <0.001), and baseline BDI ( Β =0.05±0.02; p <0.001) each individually predicted IFN-MDD incidence. In step-wise Cox regression eliminating non-significant variables, two interactions remained significantly predictive: PSQI*AA/EPA+DHA ( p =0.008) and PSS*AA/EPA+DHA ( p =0.01). Receiver Operator Curves (ROC) were used to examine the specificity and sensitivity of IFN-MDD prediction. When sleep was normal (PSQI<5), AA/EPA+DHA was strongly predictive of IFN-MDD (AUC=91±6; p =0.002). For example, among those with AA/EPA+DHA less than the median (4.15), none with PSQI<5 developed depression. Conversely, neither PSS nor PSQI was statistically associated with depression risk in those with an elevated AA/EPA+DHA ratio. These data demonstrate that the AA/EPA+DHA ratio moderates the effect of poor sleep on risk for developing IFN-MDD and may have broader implications for predicting and preventing MDD associated with inflammation.