EL SUPLEMENTO DE ACIDOS GRASOS OMEGA-3 SERIA UTIL PARA TRATAR LA DEPRESION EN LA DIABETES MELLITUS TIPO 2




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Aging and Health Research 3(3):1-4
Difundido en siicsalud: 2 oct 2023

EL SUPLEMENTO DE ACIDOS GRASOS OMEGA-3 SERIA UTIL PARA TRATAR LA DEPRESION EN LA DIABETES MELLITUS TIPO 2

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Los ácidos grasos poliinsaturados ω-3 pueden tener otros efectos beneficiosos en los pacientes con diabetes tipo 2: pueden ser útiles en la prevención y el tratamiento de la depresión, una complicación frecuente y agobiante de esta enfermedad.
Autor:
Frans Pouwer
Columnista Experto de SIIC

Institución:
Vrije Universiteit Medical Centre


Artículos publicados por Frans Pouwer
Recepción del artículo
30 de Marzo, 2007
Aprobación
27 de Septiembre, 2007
Primera edición
15 de Mayo, 2008
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Objetivos: Las pruebas sugieren firmemente que la depresión es más frecuente en los individuos con diabetes tipo 2. Sin embargo, la depresión es una entidad subdetectada y todavía se puede mejorar la eficacia de los agentes antidepresivos farmacológicos, ya que la farmacoterapia sólo conduce a la remisión en el 50% al 60% de los individuos depresivos con diabetes. El objetivo de este artículo fue revisar si es posible utilizar ácidos grasos poliinsaturados de la familia ω-3 en la prevención y el tratamiento de la depresión en la diabetes tipo 2. Métodos: Se utilizó la base de datos Medline y listas de referencias publicadas para identificar estudios que examinaran las asociaciones entre ácidos grasos poliinsaturados ω-3 y depresión. Para examinar los efectos colaterales potenciales, como aquellos sobre el control de la glucemia, se revisaron también algunos estudios en relación con el uso de suplementos de ω-3 en la diabetes tipo 2. Resultados: Algunos estudios epidemiológicos y clínicos sugieren que una ingesta elevada de ácidos grasos poliinsaturados ω-3 protege contra la aparición de depresión. También existen pruebas de que el bajo consumo de ω-3 se asocia con un riesgo aumentado de diabetes tipo 2, pero los resultados son menos concluyentes. Los resultados de ensayos aleatorizados controlados en individuos no diabéticos con depresión mayor muestran que el ácido eicosapentaenoico es un tratamiento coadyuvante eficaz de la depresión en la diabetes, mientras que el ácido docosahexanoico no lo es. Más aun, el consumo de ácidos grasos poliinsaturados ω-3 reduce el riesgo de enfermedad cardiovascular y, por lo tanto, puede disminuir indirectamente la depresión en la diabetes tipo 2, a través de la reducción de las complicaciones cardiovasculares. Conclusiones: El suplemento de ácidos grasos poliinsaturados ω-3, en particular el de ácido eicosapentaenoico, puede ser una herramienta segura y útil para reducir la incidencia de depresión y tratarla en la diabetes tipo 2. A partir de estas conclusiones, se justifica realizar otros estudios para evaluar estas hipótesis en pacientes con diabetes tipo 2.

Palabras clave
diabetes, depresión, ácidos grasos poliinsaturados omega 3, fosfolípidos, síndrome metabólico


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Abstract
Aims: Evidence strongly suggests that depression is more common in people with Type 2 diabetes mellitus. However, depression is underdetected and there is considerable room to improve the effectiveness of pharmacological antidepressant agents, as in only 50-60% of the depressed subjects with diabetes does pharmacotherapy lead to remission of depression. The aim of the present paper was to review whether polyunsaturated fatty acids (PUFA) of the ω-3 family could be used for the prevention and treatment of depression in Type 2 diabetes. Methods: Medline database and published reference lists were used to identify studies that examined the associations between ω-3 PUFA and depression. To examine potential side-effects, such as on glycaemic control, studies regarding the use of ω-3 supplements in Type 2 diabetes were also reviewed. Results: Epidemiological and clinical studies suggest that a high intake of ω-3 PUFA protects against the development of depression. There is also some evidence that a low intake of ω-3 is associated with an increased risk of Type 2 diabetes, but the results are less conclusive. Results from randomized controlled trials in non-diabetic subjects with major depression show that eicosapentaenoic acid is an effective adjunct treatment of depression in diabetes, while docosahexanoic acid is not. Moreover, consumption of ω-3 PUFA reduces the risk of cardiovascular disease and may therefore indirectly decrease depression in Type 2 diabetes, via the reduction of cardiovascular complications. Conclusions: Supplementation with ω-3 PUFA, in particular eicosapentaenoic acid, may be a safe and helpful tool to reduce the incidence of depression and to treat depression in Type 2 diabetes. Further studies are now justified to test these hypotheses in patients with Type 2 diabetes.

Key words
diabetes, depression, omega-3 polyunsaturated fatty acids, phospholipids, metabolic syndrome


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Especialidades
Principal: Salud Mental
Relacionadas: Atención Primaria, Diabetología, Epidemiología, Medicina Interna, Nutrición



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Enviar correspondencia a:
Frans Pouwer, Vrije Universiteit Medical Centre EMGO Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, Países Bajos
Patrocinio y reconocimiento:
Esta investigación recibió una beca de la Netherlands Organisation for Scientific Research (NOW-940-34-007).
Bibliografía del artículo
1. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care 21:1414-1431, 1998.
2. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020. Global burden of disease Study. Lancet 349:1498-1504, 1997.
3. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24:1069-1078, 2001.
4. Pouwer F, Beekman AT, Nijpels G, Dekker JM, Snoek FJ, Kostense PJ et al. Rates and risks for co-morbid depression in patients with type 2 diabetes mellitus: results from a community-based study. Diabetologia 46:892-898, 2003.
5. Eaton WW, Armenian H, Gallo J, Pratt L, Ford DE. Depression and risk for onset of type II diabetes. A prospective population-based study. Diabetes Care 19:1097-1102, 1996.
6. Kawakami N, Takatsuka N, Shimizu H, Ishibashi H. Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care 22:1071-1076, 1999.
7. Golden SH, Williams JE, Ford DE, Yeh HC, Paton Sanford C, Nieto FJ. Depressive symptoms and the risk of type 2 diabetes: The atherosclerosis risk in communities study. Diabetes Care 27:429-435, 2004.
8. Saydah SH, Brancati FL, Golden SH, Fradkin J, Harris MI. Depressive symptoms and the risk of type 2 diabetes mellitus in a US sample. Diabetes Metab Res Rev 19:202-208, 2003.
9. Lustman P, Clouse R. Treatment of depression in diabetes. Impact on mood and medical outcome. J Psychosom Res 53:917-924, 2002.
10. Talbot F, Nouwen A. A review of the relationship between depression and diabetes in adults: is there a link? Diabetes Care 23:1556-1562, 2000.
11. Musselman DL, Betan E, Larsen H, Phillips LS. Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biol Psychiatry 54:317-329, 2003.
12. Hibbeln JR, Salem N Jr. Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy. Am J Clin Nutr 62:1-9, 1995.
13. Horrobin DF, Bennett CN. Depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis. Possible candidate genes. Prostaglandins Leukot Essent Fatty Acids 60:217-234, 1999.
14. Rubin RR, Peyrot M. Was Willis right? Thoughts on the interaction of depression and diabetes. Diabetes Metab Res Rev 18:173-175, 2002.
15. Jacobson AM, Samson JA, Weinger K, Ryan CM. Diabetes, the brain, and behavior: is there a biological mechanism underlying the association between diabetes and depression? Int Rev Neurobiol 51:455-479, 2002.
16. Simopoulos AP. Evolutionary aspects of omega-3 fatty acids in the food supply. Prostaglandins Leukot Essent Fatty Acids 60:421-429, 1999.
17. Hibbeln JR. Fish consumption and major depression. Lancet 351:1213, 1998.
18. Tanskanen A, Hibbeln JR, Hintikka J, Haatainen K, Honkalampi K, Viinamaki H. Fish consumption, depression, and suicidality in a general population. Arch General Psychiatry 58:512-513, 2001.
19. Tanskanen A, Hibbeln JR, Tuomilehto J, Uutela A, Haukkala A, Viinamaki H et al. Fish consumption and depressive symptoms in the general population in Finland. Psychiatric Services 52:529-531, 2001.
20. Mamalakis G, Tornaritis M, Kafatos A. Depression and adipose essential polyunsaturated fatty acids. Prostaglandins Leukot Essent Fatty Acids 67:311-318, 2002.
21. Tiemeier H, Van Tuijl RH, Hofman A, Kiliaan AJ, Breteler MMB. Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr 78:40-46, 2003.
22. Suzuki S, Akechi T, Kobayashi M, Taniguchi K, Goto K, Sasaki S et al. Daily omega-3 fatty acid intake and depression in Japanses patients with newly diagnosed lung cancer. Br J Cancer 90:787-793, 2004.
23. Jacka FN, Pasco JA, Kotowicz MA, Nicholson GC, Berk M. Dietary omega-3 fatty acids and depression in a community sample. Nutritional Neuroscience 7:101-106, 2004.
24. Hakkarainen R, Partonen T, Haukka J, Virtamo J, Albanes D, Lonnqvist J. Is low dietary intake of omega-3 fatty acids associated with depression? Am J Psychiatry 161:567-569, 2004.
25. Timonen M, Horrobin D, Jokelainen J, Laitinen J, Herva A, Rasanen P. Fish consumption and depression: the Northern Finland 1966 birth cohort study. J Affect Disord 82:447-452, 2004.
26. Mamalakis G, Kiriakakis M, Tsibinos G, Kafatos A. Depression and adipose polyunsaturated fatty acids in the survivors of the seven countries study population of Crete. Prostaglandins Leukot Essent Fatty Acids 70:495-501, 2004.
27. Frasure-Smith N, Lesperance F, Julien P. Major depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndromes. Biol Psychiatry 55:891-896, 2004.
28. Adams PB, Lawson S, Sanigorski A, Sinclair AJ. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids 31(Suppl.):S157-161, 1996.
29. Maes M, Smith R, Christophe A, Cosyns P, Desnyder R, Meltzer H. Fatty acid composition in major depression: decreased omega 3 fractions in cholesteryl esters and increased C20:4 omega-6/C20:5 omega-3 ratio in cholesteryl esters and phospholipids. J Affect Disord 38:35-46, 1996.
30. Edwards R, Peet M, Shay J, Horrobin D. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord 48:149-155, 1998.
31. Peet M, Murphy B, Shay J, Horrobin D. Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients. Biol Psychiatry 43:315-319, 1998.
32. Maes M, Christophe A, Delanghe J, Altamura C, Neels H, Meltzer HY. Lowered omega-3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res 85:275-291, 1999.
33. Assies J, Lok A, Bockting CL, Weverling GJ, Lieverse R, Visser I et al. Fatty acids and homocysteine levels in patients with recurrent depression: an explorative pilot study. Prostaglandins Leukot Essent Fatty Acids 70:349-356, 2004.
34. Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E. Omega-3 fatty acids in bipolar disorder: a preliminary double blind, placebo-controlled trial. Arch General Psychiatry 56:407-412, 1999.
35. Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry 159:477-479, 2002.
36. Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch General Psychiatry 59:913-919, 2002.
37. Marangell LB, Martinez JM, Zboyan HA, Kertz B, Florence Sueng Kim H, Puryear LJ. A double-blind placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry 160:996-998, 2003.
38. Su KP, Hunag SY, Chiu CC, Shen WW. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol 13:267-271, 2003.
39. Assies J, Lieverse R, Vreken P, Wanders RJ, Dingemans PM, Linszen DH. Significantly reduced docosahexaenoic and docosapentaenoic acid concentrations in erythrocyte membranes from schizophrenic patients compared with a carefully matched control group. Biol Psychiatry 49:510-522, 2001.
40. Peet M. Eicosapentaenoic acid in the treatment of schizophrenia and depression: rationale and preliminary double-blind clinical trial results. Prostaglandins Leukot Essent Fatty Acids 69:477-485, 2003.
41. Lund EK, Harvey LJ, Ladha S, Clark DC, Johnson IT. Effects of diet-ary fish oil supplementation on the phospholipid composition and fluidity of cell membranes from human volunteers. Ann Nutr Metab 43:290-300, 1999.
42. Block ER, Edwards D. Effect of plasma membrane fluidity on serotonin transport by endothelial cells. Am J Physiol 253:C672-678, 1987.
43. Hibbeln JR, Linnoila M, Umhau JC, Rawlings R, George DT, Salem N. Essential fatty acids predict metabolites of serotonin and dopamine in cerebrospinal fluid among healthy control subjects, and early- and late-onset alcoholics. Biol Psychiatry 44:235-242, 1998.
44. Maes M, Smith RS. Fatty acids, cytokines, and major depression. Biol Psychiatry 43:313-314, 1998.
45. Hu FB, van Dam RM, Liu S. Diet and risk of Type II diabetes: the role of types of fat and carbohydrate. Diabetologia 44:805-817, 2001.
46. Feskens EJ, Virtanen SM, Rasanen L, Tuomilehto J, Stengard J, Pekkanen J. Dietary factors determining diabetes and impaired glucose tolerance. A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study. Diabetes Care 18:1104-1112, 1995.
47. Feskens EJ, Bowles CH, Kromhout D. Inverse association between fish intake and risk of glucose intolerance in normoglycemic elderly men and women. Diabetes Care 14:935-941, 1991.
48. Feskens EJ, Kromhout D. Epidemiologic studies on Eskimos and fish intake. Ann NY Acad Sci 683:9-15, 1993.
49. Jorgensen ME, Bjeregaard P, Borch-Johnsen K. Diabetes and impaired glucose tolerance among the Inuit population of Greenland. Diabetes Care 25:1766-1771, 2002.
50. Salmeron J, Hu FB, Manson JE, Stampfer MJ, Colditz GA, Rimm EB. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr 73:1019-1026, 2001.
51. Meyer KA, Kushi LH, Jacobs DR Jr, Folsom AR. Dietary fat and incidence of type 2 diabetes in older Iowa women. Diabetes Care 24:1528-1535, 2001.
52. Marshall JA, Bessesen DH, Hamman RF. High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: the San Luis Valley Diabetes Study. Diabetologia 40:430-438, 1997.
53. Van Dam RM, Willett WC, Rimm EB, Stampfer MJ, Hu FB. Dietary fat and meat intake in relation to risk of type 2 diabetes in men. Diabetes Care 25:417-424, 2002.
54. Vessby B, Unsitupa M, Hermansen K, Riccardi G, Rivellese AA, Tapsell LC et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia 44:312-319, 2001.
55. Toft I, Bonaa KH, Ingebretsen OC, Nordoy A, Jenssen T. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 123:911-918, 1995.
56. Friedberg CE, Janssen MJ, Heine RJ, Grobbee DE. Fish oil and glycemic control in diabetes. A meta-analysis. Diabetes Care 21:494-500, 1998.
57. Montori VM, Farmer A, Wollan PC, Dinneen SF. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care 23:1407-1415, 2000.
58. Weber P, Raederstorff D. Triglyceride-lowering effect of omega-3 long chain polyunsaturated fatty acids-a review. Nutr Metab Cardiovasc Dis 10:28-37, 2000.
59. Appel LJ, Miller ER 3rd, Seidler AJ, Whelton PK. Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials. Arch Intern Med 153:1429-1438, 1993.
60. Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids and cardiovascular disease. Circulation 106:2747-2757, 2002.
61. Kris-Etherton PM, Harris WS, Appel LJ; AHA Nutrition Committee. American Heart Association. Omega-3 fatty acids and cardiovascular disease. New recommendations from the American Heart Association. Arterioscler Thromb Vasc Biol 23:151-152, 2003.
62. Rudisch B, Nemeroff CB. Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatry 54:227-240, 2003.
63. Rugulies R. Depression as a predictor for coronary heart disease: a review and meta-analysis (1). Am J Prev Med 23:51-61, 2002.
64. Mulrow CD, Williams JWR, Gerety MB, Ramirez G, Montiel OM, Kerber C. Case-finding instruments for depression in primary care settings. Ann Intern Med 122:913-921, 1995.
65. Penninx BW, Beekman AT, Honig A, Deeg DJ, Schoevers RA, van Eijk JT et al. Depression and cardiac mortality: results from a community-based longitudinal study. Arch Gen Psychiatry 58:221-227, 2001.
66. Burg MM, Abrams D. Depression in chronic medical illness: the case of coronary heart disease. J Clin Psychol 57:1323-1337, 2001.
67. Lloyd CE, Kuller LH, Ellis D, Becker DJ, Wing RR, Orchard TJ. Coronary artery disease in IDDM. Gender differences in risk factors but not risk. Arterioscler Thromb Vasc Biol 16:720-726, 1996.
68. Forrest KY, Becker DJ, Kuller LH, Wolfson SK, Orchard TJ. Are predictors of coronary heart disease and lower-extremity arterial disease in type 1 diabetes the same? A prospective study. Atherosclerosis 148:159-169, 2000.
69. Peyrot M, Rubin RR. Persistence of depressive symptoms in diabetic adults. Diabetes Care 22:448-452, 1999.
70. Takahata K, Monobe K, Tada M, Weber PC. The benefits and risks of n-3 polyunsaturated fatty acids. Biosci Biotechnol Biochem 62:2079-2085, 1998.
71. Harris WS, Ginsberg HN, Arunakul N, Shachter NS, Windsor SL, Adams M. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk 4:385-391, 1997.
72. Katon WJ. Clinical and health services relationships between depression, depressive symptoms, and general medical illness. Biol Psychiat 54:216-226, 2003.
73. Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson JL, Garg A. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 25:148-198, 2002.

 
 
 
 
 
 
 
 
 
 
 
 
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