Introduction
Considering that estradiol (E2) and n-3 polyunsaturated fatty acids (PUFAs)
have roles in neurogenesis and in neurotransmission, we examined whether the association
of PUFAs with incident depressive symptoms in postmenopausal women is modified by
hormone therapy (HT) use or estrogen status.
Methods
Women (N=1616) free of depressive symptoms at baseline (2000-02) in the
Multi-Ethnic Study of Atherosclerosis were classified by HT usage and quartiles of
dietary eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and the sum EPA+DHA.
Women with serum E2 ≤0.073 nmol/L (sample median), were classified low on E2.
Poisson regression was used to model incident depressive symptoms at examination 3
(2004-05), defined by the Center for Epidemiological Studies Depression Scale ≥16
or taking an antidepressant, first as a function of HT use and n-3 PUFA quartiles, and
second, as a function of low E2 status and n-3 PUFA quartiles.
Results
Among HT non-users, positive, graded relationships (p-trends≤0.003) were
found between PUFAs and incident depressive symptoms. Compared to the lowest quartile,
the adjusted risk ratios (RRs) for the highest were 2.10, 2.39, and 2.04 for EPA, DHA,
and EPA+DHA, respectively. For HT users, no associations were seen. When analyses were
run for E2 status, the RRs over quartiles of the PUFAs were positive and graded for low
E2 women, but were null for High E2 women.
Conclusions
Higher intakes of DHA and EPA were associated with higher risk of depressive
symptoms in nonusers of HT, contrary to hypothesis.