Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression

Abstract

In this study of 20 moderately to severely depressed patients, diagnosed using current research diagnostic criteria and excluding known bipolar affective disorder and reactive depression, we investigated relationships between severity of depression and levels and ratios of n-3 and n-6 long-chain polyunsaturated fatty acids (PUFA) in plasma and erythrocyte phospholipids (PL). Severity of depression was measured using the 21-item Hamilton depression rating scale (HRS) and a second linear rating scale (LRS) of severity of depressive symptoms that omitted anxiety symptoms. There was a significant correlation between the ratio of erythrocyte PL arachidonic acid (AA) to eicosapentaenoic acid (EPA) and severity of depression as rated by the HRS (P<0.05) and the LRS for depression (P< 0.01). There was also a significant negative correlation between erythrocyte EPA and the LRS (P<0.05). The AA/EPA ratio in plasma PL and the ratio of erythrocyte long-chain (C20 and C22 carbon) n-6 to long-chain n-3 PUFA were also significantly correlated with the LRS (P<0.05). These findings do not appear to be simply explained by differences in dietary intake of EPA. We cannot determine whether the high ratios of AA/EPA in both plasma and erythrocyte PL are the result of depression or whether tissue PUFA change predate the depressive symptoms. We suggest, however, that our findings provide a basis for studying the effect of the nutritional supplementation of depressed subjects, aimed at reducing the AA/EPA ratio in tissues and severity of depression.

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Abbreviations

AA:

arachidonic acid

ALA:

α-linolenic acid

EPA:

eicosapentaenoic acid

HRS:

Hamilton rating scale

LA:

linoleic acid

LRS:

linear rating scale

PL:

phospholipids

PUFA:

polyunsaturated fatty acids

References

  1. 1.

    Klerman, G. (1988) The Current Age of Youthful Melancholia,Brit. J. Psych. 152, 4–14.

    CAS  Article  Google Scholar 

  2. 2.

    Klerman, G., and Weissman, M. (1989) Increasing Rates of Depression,JAMA 261, 2229–2235.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Budowski, P. (1988) Omega 3 Fatty Acids in Health and Disease,World. Rev. Nutr. Dietet. 57, 214–274.

    CAS  Google Scholar 

  4. 4.

    Leaf, A., and Weber, P.C. (1987). A New Era for the Science of Nutrition,Am. J. Clin. Nutr. 45, 1048–1053.

    PubMed  CAS  Google Scholar 

  5. 5.

    Eaton, S.B., and Konner, M. (1985) Paleolithic Nutrition. A Consideration of Its Nature and Current Implications,New Eng. J. Med. 312, 283–289.

    PubMed  CAS  Article  Google Scholar 

  6. 6.

    Endres, S. (1993) Messengers and Mediators: Interactions Among Lipids, Eicosanoids and Cytokines,Am. J. Clin. Nutr. 57 (Suppl.), 798–800.

    Google Scholar 

  7. 7.

    Dolecek, T.A. (1992) Epidemiological Evidence of Relationships Between Dietary Polyunsaturated Fatty Acids and Mortality in the Multiple Risk Factor Intervention Trial,Proc. Soc. Exp. Biol. Med. 200, 177–182.

    PubMed  CAS  Google Scholar 

  8. 8.

    Smith, R.S. (1991) The Macrophage Theory of Depression,Medical Hypotheses 35, 298–306.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Hibbeln, J.R., and Salem, Jr., N. (1995) Dietary Polyunsaturated Fats and Depression: When Cholesterol Alone Doesn't Satisfy,Am. J. Clin. Nutr. 62:1–9.

    PubMed  CAS  Google Scholar 

  10. 10.

    Lieb, J., Karmali, R., and Horrobin, D. (1983) Elevated Levels of Prostaglandins E2 and Thromboxane B2 in Depression,Prostaglandins Leukotrienes Med. 10, 361–367.

    Article  CAS  Google Scholar 

  11. 11.

    DSM IV (1994)Diagnostic and Statistical Manual of Mental Disorders, 4th edn., American Psychiatric Association, Washington, DC.

    Google Scholar 

  12. 12.

    Hamilton, M. (1960) A Rating Scale for Depression,J. Neutrol. Neurosurg. Psychiat. 23, 56–62.

    CAS  Google Scholar 

  13. 13.

    Wheeler, C., Rutishauser, I., Conn, J., and O'Dea, K. (1994) Reproducibility of a Meal-Based Food Frequency Questionnaire. The Influence of Format and Time Interval Between Questionnaires,Europ. J. Clin. Invest. 48, 795–809.

    CAS  Google Scholar 

  14. 14.

    Mann, N.J., Johnson, L.J., Warrick, G.E., and Sinclair, A.J. (1995) The Arachidonic Acid Content of the Australian Diet is Lower than Previously Estimated,J. Nutr. 125: 2528–2535.

    PubMed  CAS  Google Scholar 

  15. 15.

    Sinclair, A.J., O'Dea, K., Dunstan, G., Ireland, P.D., and Niall, M. (1987) Effects on Plasma Lipids and Fatty Acid Composition of Very Low Fat Diets Enriched with Fish or Kangaroo Meat,Lipids 22, 523–529.

    PubMed  Article  CAS  Google Scholar 

  16. 17.

    Sinclair, A.J., O'Dea, K. and Johnson, L. (1994) Estimation of the n-3 Status in a Group of Urban Australians by the Analysis of Plasma Phospholipid Fatty Acids,Aust. J. Nutr. Dietet. 51, 53–56.

    Google Scholar 

  17. 18.

    Lands, W.E.M., Libelt, B., Morris, A., Kramer, N.C., Prewitt, T.E., Bowen, P., Schmeisser, D., Davidson, M.H., and Burns, J.H. (1992) Maintenance of Lower Proportions of n-6 Eicosanoid Precursors in Phospholipids of Human Plasma in Response to Added n-3 Fatty Acids,Biochim. Biophys. Acta 1180, 147–162.

    PubMed  CAS  Google Scholar 

  18. 19.

    Bjerve, K.S., Brubakk, A.M., Fougner, K.J., Johnsen, H., Midjthell, K., and Vik, T. (1993) Omega 3 Fatty Acids: Essential Fatty Acids with Important Biological Effects and Serum Phospholipid Fatty Acids as Markers of Dietary W3-Fatty Acid Intake,Am. J. Clin. Nutr. 57 (Suppl.), 801–806.

    Google Scholar 

  19. 20.

    Brown, A.J., Pang, E., and Roberts, D.C.K. (1991) Erythrocyte Eicosapentaenoic Acid versus Docosahexaenoic Acid as a Marker for Fish and Fish Oil Consumption,Prostaglandins Leukotrienes Essent. Fatty Acids 44, 103–106.

    Article  CAS  Google Scholar 

  20. 21.

    NHMRC (1992) Report of Working Party of the National Health and Medical Research Council,The Role of Polyunsaturated Fatty Acids in the Australian Diet, Australian Government Publishing Service, Canberra.

    Google Scholar 

  21. 22.

    Nettleton, J.A. (1991) Omega 3 Fatty Acids: Comparison of Plant and Seafood Sources in Human Nutrition,J. Amer. Dietet. Assoc. 91, 331–337.

    CAS  Google Scholar 

  22. 23.

    Ellis, F.R., and Sanders, T.A.B. (1977) Long Chain Polyunsaturated Fatty Acids in Endogenous Depression,J. Neurol. Neurosurg. Psychiatr. 40, 168–169.

    PubMed  CAS  Article  Google Scholar 

  23. 24.

    Fehily, A.M.A., Bowey, O.A.M., Ellis, F.R., Meade, B.W. and Dickerson, J.W.T. (1981) Plasma and Erythrocyte Membrane Long Chain Polyunsaturated Fatty Acids in Endogenous Depression,Neurochem. Internat. 3, 37–42.

    Article  CAS  Google Scholar 

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Correspondence to Andrew J. Sinclair.

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Adams, P.B., Lawson, S., Sanigorski, A. et al. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids 31, S157–S161 (1996). https://doi.org/10.1007/BF02637069

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Keywords

  • Depressive Symptom
  • Anorexia Nervosa
  • Food Frequency Questionnaire
  • Eicosapentaenoic Acid
  • Multiple Risk Factor Intervention Trial