Cholesterol, omega-3 fatty acids, and suicide risk: Empirical evidence and pathophysiological hypotheses
Cholesterol, omega-3 fatty acids, and suicide risk: Empirical evidence and pathophysiological hypotheses
复制标题
DOI：
10.1055/s-2001-17564
复制
发表时间：
2001-10-01
影响因子：
0.6
通讯作者：
Bronisch, T
中科院分区：
文献类型：
--
作者：
Brunner, J;Parhofer, KG;Bronisch, T
在精神病患者中的研究描述了较低血清胆固醇浓度、自杀倾向、抑郁、冲动和攻击性之间的关联，这并不完全归因于抑郁相关的营养不良和体重减轻。有证据表明，前额叶皮质中的多巴胺能缺陷可能使易受伤害的受试者在应激性生活事件中易发生冲动、自我攻击和自杀行为。体外研究、动物实验和人体体内研究支持这样的假设：胆固醇降低可能导致自杀受试者中假设的血清素能异常。最近有人假设，多不饱和脂肪酸，特别是ω-3脂肪酸的摄入量减少可能是抑郁症和自杀的危险因素。来自健康志愿者的人体研究数据表明，增加omega-3脂肪酸的饮食摄入量可能会增加中枢神经系统的活动，减少冲动和攻击行为。早期的流行病学研究表明，低胆固醇浓度和自杀风险增加之间存在关联。然而，最近的流行病学研究采用了更多的样本和更长的随访期，甚至显示在控制了潜在的混杂变量后，胆固醇浓度与自杀风险之间存在正相关性。他汀类药物（辛伐他汀、洛伐他汀、普伐他汀）的大型试验并未显示自杀死亡率增加。
Studies in psychiatric patients described an association between lower serum cholesterol concentrations, suicidality, depression, impulsivity, and aggression which is not entirely attributable to depression-related malnutrition and weight-loss. Several lines of evidence suggest that a serotonergic deficit in the prefrontal cortex may predispose vulnerable subjects to impulsive, autoaggressive, and suicidal behaviour in stressful life-events. In-vitro studies, animal experiments, and human in-vivo studies support the hypothesis that cholesterol reduction may contribute to the serotonergic abnormalities which have been postulated in suicidal subjects. Recently it was hypothesized that decreased consumption of polyunsaturated fatty acids, especially omega-3 fatty acids, may be a risk factor for depression and suicide. Data from human studies in healthy volunteers suggest that increasing the dietary intake of omega-3 fatty acids may increase central serotonergic activity and reduce impulsive and aggressive behaviours. Earlier epidemiological studies showed an association between low cholesterol concentrations and increased suicide risk. Recent epidemiological studies with greater samples and longer follow-up periods, however, even showed a positive correlation between cholesterol concentrations and suicide risk after controlling for potential confounding variables. Large trials of statins (simvastatin, lovastatin, pravastatin) did not show an increase of suicide mortality.