[논문]Association between Omega Fatty Acid Intake and Suicidality : Sex Differences in the General Korean Population

Hur, Yang-Im; Lee, Jung Hyun

doi:10.22722/kjpm.2019.27.2.181

Association between Omega Fatty Acid Intake and Suicidality : Sex Differences in the General Korean Population 원문보기

精神身體醫學 = Korean journal of psychosomatic medicine, v.27 no.2, 2019년, pp.181 - 190

Hur, Yang-Im (Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine) , Lee, Jung Hyun (Department of Psychiatry, National Center for Mental Health)

Abstract ▼ AI-Helper

Objectives : Epidemiological studies in other countries show that a low intake of omega-3 fatty acids (FAs) increases the risk of depression or suicidality. However, no studies have investigated the associations of suicidality with omega-3 FAs in Korea. Hence, this cross-sectional study aimed to investigate the effects of omega FAs on suicidality in the general South Korean population. Methods : The data in this study were sourced from adults (n=215,860) who completed the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), and the associations between omega FAs and suicidality were analyzed using multivariate logistic regressions. Results : Our results demonstrated that high omega-3 FA intake was associated with a decreased risk of suicide (OR=0.83, 95% CI : 0.71-0.98) and the high omega-6 to omega-3 FA ratio was associated with an increased risk of suicide (OR=1.25, 95% CI : 1.02-1.54). Additionally, a high intake of omega-3 FAs was associated with a decreased risk of suicide in men, but not in women (OR=0.72, 95% CI : 0.59-0.88). Conclusions : Overall, our findings suggest that a lower intake of omega-3 FA is associated with the increased risk of suicidality in the general Korean population, especially in men.

주제어

표/그림 (4)

표 Table 1. Odds ratios for suicidality depending on demographic and clinical characteristics in all study population (n=10,589)
표 Table 2. Unadjusted and adjusted odds ratio for suicidality by n-3 and n-6 fatty acid intakes
그림 Fig. 1. Predictive margins of sex predicting suicidality by n-3 FA intake.
표 Table 3. Associations of omega-3 and omega-6 fatty acid intakes with suicidality by gender

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문제 정의

⁵⁴⁾ Future studies with additional dietary information related to mental health are needed to determine the relationships of n-3 and n-6 FAs with suicidality. Our study had an important strength, in that, to the best of our knowledge, this was the first study to evaluate the relationship between n-3 and n-6 FAs and suicidality in the general Korean population. The participants in the KNHANES VI were randomly selected from among the community-dwelling population ; therefore, our results can be generalized to adults in Korea.
The purpose of this study was to evaluate the association between the consumption of omega FAs and suicidality. Using data from a nationally representative survey, we found that higher n-3 intake and n-3/n-6 ratio were associated with a lower risk of suicidality.

가설 설정

2) Have you ever made a plan to commit suicide in the last year?” (suicidal plan), and 3) “Have you ever actually attempted to commit suicide in the last year?” (suicidal attempts). Participants who answered “yes” to any one of the three questions were assigned to the suicidality group, and patients who answered “no” to all questions were assigned to the control group.
Hence, the current study examined the associations between omega FA intake and the risk of suicide in a nationally representative sample of the Korean population. We hypothesized that the consumption of omega-3 FAs would be associated with a decreased risk of suicidality. Additionally, we evaluated the effect of omega FA intake on suicidality between sexes.

제안 방법

²⁴⁾ Using stratified multistage clustered probability sampling, nutritional status and health-related information was obtained from clinical examination, face-to-face interviews, and self-report questionnaires. Estimated nutrient intake data, which were calculated using the Korean National Rural Living Science Institute and Korea Health Industry Development Institute databases^25,26) was obtained by trained dietitians in homes of the participants from surveys on one-day (24 hours) dietary recalls. The food intake questionnaire has been designed as an open-ended survey for reporting various dishes and foods using the 24-h recall method with various measuring aids.
0 (Stata Corporation, TX, USA). Given the complex and multistage sampling design, all analyses were weighted to adjust for the non-response rate using post-stratification. The estimated prevalence and associations with robust standard errors were calculated with survey command (svy) in STATA.
The second model included all covariates within the first model, along with additional covariates: severity of alcohol use, smoking status, total calorie intake, monosaturated and saturated FA intake, BMI, history of depression, and perceived stress. In addition, separated logistic regressions were performed to assess the interaction between sex and omega FA intake on suicidality.
We used two multivariate models that are described below. The first model was constructed using covariates that included age, sex, marital status, education, and household income. The second model included all covariates within the first model, along with additional covariates: severity of alcohol use, smoking status, total calorie intake, monosaturated and saturated FA intake, BMI, history of depression, and perceived stress.
The first model was constructed using covariates that included age, sex, marital status, education, and household income. The second model included all covariates within the first model, along with additional covariates: severity of alcohol use, smoking status, total calorie intake, monosaturated and saturated FA intake, BMI, history of depression, and perceived stress. In addition, separated logistic regressions were performed to assess the interaction between sex and omega FA intake on suicidality.
Univariate logistic regressions were performed to compare sociodemographic and clinical characteristics between the control and suicidality groups. To analyze the association between omega FA intake and suicidal risk, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using univariate and multivariate logistic regression tests.

대상 데이터

A total of 22,948 individuals (10,411 men and 12,537 women) participated in the survey, and there was a 78.8% response rate. We excluded 12,359 participants who were under 19 years of age and participants who did not provide both one-day dietary recall and suicide-related data.
We excluded 12,359 participants who were under 19 years of age and participants who did not provide both one-day dietary recall and suicide-related data. As a result, the total number of eligible participants was 10,589 (4,529 men and 6,060 women).

데이터처리

Univariate logistic regressions were performed to compare sociodemographic and clinical characteristics between the control and suicidality groups. To analyze the association between omega FA intake and suicidal risk, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using univariate and multivariate logistic regression tests. We used two multivariate models that are described below.

성능/효과

15). After adjusting for sociodemographic variables (age, sex, marital status, education, and house income), n-3 and n-6 FA intake continued to be associated with a significant decreased risk of suicide (n-3 FAs, OR=0.82, 95% CI : 0.71-0.95 ; n-6 FAs, OR=0.79, 95% CI : 0.67-0.94). In the final analysis with all covariates, n-3 FA intake (OR=0.
72), were significantly associated with an increased risk of suicide. As expected, the risk of suicide was 16-fold greater for participants who had a history of depressive symptoms (OR=16.81, 95% CI : 13.41-21.07) and 5-fold greater for those with perceived stress (OR=5.58, 95% CI : 4.52-6.88).
94). In the final analysis with all covariates, n-3 FA intake (OR=0.82, 95% CI : 0.70-0.96) demonstrated a significant association with a reduced risk of suicide. The ratio of n-6/n-3 was also significantly associated with an increased risk of suicide (OR=1.
Table 2 contains the results from the logistic regressions that analyzed the association between omega FA intake and the risk of suicide. In the univariate analysis, n-3 (OR=0.75, 95% CI : 0.65-0.88) and n-6 FA intake (OR=0.65, 95% CI : 0.56-0.76) were associated with a significantly decreased risk of suicide. However, the ratio of n-6 to n-3 FAs was not significantly associated with suicidality (OR=0.
52), compared to university graduates. The lowest quartile group in household income showed an increased risk, compared to other quartile groups, such as the low-middle (OR=0.53, 95% CI : 0.40-0.71), high-middle (OR=0.32, 95% CI : 0.24-0.42), and highest quartiles (OR=0.25, 95% CI : 0.19-0.36), respectively. Lifestyle factors, including current smoking (OR=1.

후속연구

Our results also highlight the importance of n-3 FA intake for promoting and maintaining mental health. Additionally, future prospective studies should clarify whether n-3-FAs plays a causal role in suicidality and if n-3 FA intake can be manipulated to reduce the risk of suicide.
Additionally, information regarding potential confounding factors, including medication for depression and other mental illnesses, was insufficient in our study. Further validated studies are needed to confirm our hypothesis. Finally, dietary intake of subtype n-3 FAs (DHA and EPA) and alpha-linolenic acid might be more relevant to mental status and behavior.

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