Omega-3 polyunsaturated fatty acids and mortality risk in depression: immune-inflammatory mediation in NHANES 1999-2018
Abstract
BACKGROUND: Immune-inflammatory deregulation in depression may contribute to elevated risk of subsequent mortality. While dietary omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), are known to confer neuroprotective effects for their anti-inflammatory properties, population-based evidence regarding their survival benefits and underlying mechanisms in depression remain scarce. This study aimed to investigate association between dietary omega-3 PUFAs and mortality risk in depressed individuals and identify immune-inflammatory mediation underlying mortality reductions. METHODS: Totally, 6,782 depressed individuals aged 20 years and above in 10 cycles (1999–2018) of the National Health and Nutrition Examination Survey (NHANES) were analyzed. Omega-3 PUFAs intake (total and individual) was assessed through 24-hour dietary recalls. Cox proportional hazard models were used to calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for morality risk across omega-3 PUFA quartiles. Quantile-based g-computation model determined individual PUFA contributions, while mediation analysis evaluated the role of Geriatric Nutritional Risk Index (GNRI) and Systemic Immune-Inflammation Index (SII) in mortality reductions. RESULTS: Over the follow-up period of 679,294 person years, 1,281 deaths were documented. The HRs for the highest versus lowest quartile of omega-3 PUFAs were 0.76 (95%…
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