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臨床情報「注意欠如多動性障害(Attention Deficit Hyperactivity Disorder :ADHD)と自閉性スペクトラム障害(Autistic Spectrum Disorder :ASD)のDHA、EPA、オメガ6/オメガ3の値について」

今回は、注意欠如多動性障害(Attention Deficit Hyperactivity Disorder :ADHD)と自閉性スペクトラム障害(Autistic Spectrum Disorder :ASD)のDHA、EPA、オメガ6/オメガ3の値についての論文です。


PLoS One. 2016 May 27;11(5):e0156432.

Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls.

Parletta N1, Niyonsenga T1, Duff J2,3.


Abstract
BACKGROUND:
There is evidence that children with Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Spectrum Disorder (ASD) have lower omega-3 polyunsaturated fatty acid (n-3 PUFA) levels compared with controls and conflicting evidence regarding omega-6 (n-6) PUFA levels.
OBJECTIVES:
This study investigated whether erythrocyte n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were lower and n-6 PUFA arachidonic acid (AA) higher in children with ADHD, ASD and controls, and whether lower n-3 and higher n-6 PUFAs correlated with poorer scores on the Australian Twin Behaviour Rating Scale (ATBRS; ADHD symptoms) and Test of Variable Attention (TOVA) in children with ADHD, and Childhood Autism Rating Scale (CARS) in children with ASD.
METHODS:
Assessments and blood samples of 565 children aged 3-17 years with ADHD (n = 401), ASD (n = 85) or controls (n = 79) were analysed. One-way ANOVAs with Tukey's post-hoc analysis investigated differences in PUFA levels between groups and Pearson's correlations investigated correlations between PUFA levels and ATBRS, TOVA and CARS scores.
RESULTS:
Children with ADHD and ASD had lower DHA, EPA and AA, higher AA/EPA ratio and lower n-3/n-6 than controls (P<0.001 except AA between ADHD and controls: P = 0.047). Children with ASD had lower DHA, EPA and AA than children with ADHD (P<0.001 for all comparisons). ATBRS scores correlated negatively with EPA (r = -.294, P<0.001), DHA (r = -.424, P<0.001), n-3/n-6 (r = -.477, P<0.001) and positively with AA/EPA (r = .222, P <.01). TOVA scores correlated positively with DHA (r = .610, P<0.001), EPA (r = .418, P<0.001) AA (r = .199, P<0.001), and n-3/n-6 (r = .509, P<0.001) and negatively with AA/EPA (r = -.243, P<0.001). CARS scores correlated significantly with DHA (r = .328, P = 0.002), EPA (r = -.225, P = 0.038) and AA (r = .251, P = 0.021).
CONCLUSIONS:
Children with ADHD and ASD had low levels of EPA, DHA and AA and high ratio of n-6/n-3 PUFAs and these correlated significantly with symptoms. Future research should further investigate abnormal fatty acid metabolism in these disorders.


ADHD、ASD群と、コントロール群(定型発達群)を比較したところ、ADHD、ASD群の子どもの方が、EPA(エイコサペンタエン酸)、DHA(ドコサヘキサエン酸)、AA(アラキドン酸)が低く、オメガ6系多価不飽和脂肪酸/オメガ3系多価不飽和脂肪酸の割合が高い結果となった。

この結果から、低くなっているオメガ3、EPA、DHAを食事やサプリメントで補充することでなんらかの症状が改善する可能性も考えられます。

実際にADHDに対するオメガ3の有効性の報告などでていますので、EPA、DHAなどのADHD、ASDの発達障害、その他、うつ病、不安障害などへの報告についても調べてまた報告します。


記事作成:加藤晃司(医療法人永朋会)
     専門:児童精神科(日本児童青年期精神医学会認定医、子どものこころ専門医)