重鬱症患者之營養素攝取與血液脂肪酸之探討
Nutrient Intake and Blood Fatty Acid Profile in Patients with Major
Depressive Disorder
中文摘要 繼癌症、愛滋病之後，憂鬱症已成為二十一世紀三大疾病之一。有許多研究指出 體內多元不飽和脂肪酸的代謝與憂鬱症有高度的相關性，其中又以n-3、n-6 族 最為明確。本研究旨在探討重鬱症患者之營養素攝取與血液脂肪酸組成。研究於 國立台灣大學附設醫院精神科門診招募31 位重鬱症患者，以及 39 位健康檢查者 (對照組)，進行飲食評估及血液分析。研究結果發現：重鬱症患者血清全蛋白質、 球蛋白、白蛋白、嗜中性白血球及鉀離子顯著高於正常組(p<0.05)，血清中之直 接型膽紅素、全膽紅素、鈉離子及磷離子濃度則顯著低於正常組(p<0.05)。營養 素攝取：重鬱症患者於熱量、三大營養素(醣類、蛋白質、脂質)、色胺酸、酪胺 酸、膽固醇、單元、多元、n-6、n-3 不飽和脂肪酸、菸鹼素、維生素 E、B1、 B6、B12、C、鈉、鉀、鈣、鎂、磷、鐵及鋅之每日平均攝取量顯著低於正常組 (p<0.005)。重鬱組血漿之次亞麻油酸(ALA)顯著高於正常組，而二十二碳六烯酸 (DHA)及總 n-3 多元不飽和脂肪酸顯著低於正常組。重鬱組紅血球細胞膜之亞麻 油酸(LA)、花生油酸(AA)顯著高於正常組，而 docosatetraenoic(DTA)顯著低於正 常組。重鬱組紅血球細胞膜花生油酸(AA)/二十二碳六烯酸(EPA)顯著高於正常 組；血漿中總n-6 多元不飽和脂肪酸/總 n-3 多元不飽和脂肪酸值顯著高於正常 組。重鬱組憂鬱程度與紅血球細胞膜磷脂質之二十碳五烯酸(EPA)及二十二碳六 烯酸(DHA)呈現顯著負相關。由以上結果顯示，紅血球細胞膜磷脂質中二十碳五 烯酸(EPA)、二十二碳六烯酸(DHA)可當作一項輔助判定憂鬱症嚴重程度的重要 指標。 關鍵字：重鬱症、二十碳五烯酸、二十二碳六烯酸、n-3 脂肪酸 英文摘要The proposed study was to evaluate nutrients intake and blood fatty acid profile in patients with major depressive disorder. Thirty-one major depressive disorder patients were recruited from Department of Psychiatry, National Taiwan University Hospital. A total thirty-nine age-sex matched health examination controls were recruited as controlled subject. In dietary assessment, the three-day dietary record were used to evaluate nutrients intake. Blood samples were collected for plasma and RBC
phospholipids fatty acid profile analysis. In results, the intake of calorie, protein, fat, carbohydrate, tryptophan, tyrosine, cholesterol, n-3, n-6 PUFA, MUFA, PUFA, Vit E, B1, B12, B6, Vit C, niacin, Na, K, Ca, Mg, P, Fe, Zn in major depressive patient was significant less than of control subjects. The fatty acid composition of plasma lipid
showed α—linolenic acid, docosahexaenoic acid and n-3 PUFA were significanty lower in major depressive patients than control. The fatty acid composition of erythrocyte membrane phospholipid showed linoleic acid and arachidonic acid were statistically significant higher in major depressive patients than controls, the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) were significant higher than controls. In clinical psycharitc assessment the Hamiltom Rating Scale for Depression correlated negatively with concentration of eicosapentaenoic acid and
docosahexaenoic acid of erythrocyte membrane phospholipids. According to the result, we concluded the eicosapentaenoic acid and docosahexaenoic acid of erythrocyte membrane phospholipids could be one of marker to assist the judgement of severity of depression.
