Brief reportLower serum vitamin E concentrations in major depression: Another marker of lowered antioxidant defenses in that illness
Introduction
Defective plasma antioxidant defenses, enhanced susceptibility to lipid peroxidation and increased oxidative stress may occur in major depression. Plasma tryptophan and tyrosine (Maes et al., 1994a, Maes and Meltzer, 1995), which have antioxidant activity (Meucci and Mele, 1997), and serum albumin (Swartz, 1990, Maes et al., 1991, Van Hunsel et al., 1996), a major contributor to the oxygen radical absorbing capacity (Cao et al., 1993) are significantly decreased in depression. In mice, a significant depletion of brain glutathione, another antioxidant, occurs in stress-induced depression (Gutteridge and Halliwell, 1994, Pal and Dandiya, 1994).
Depression is associated with significantly lower ω3 polyunsaturated fatty acid (PUFA) fractions (Maes et al., 1996a, Maes and Smith, 1998, Peet et al., 1998) and oxidative potential index (OPI) of serum phospholipids (Maes et al., 1999), suggesting oxidative damage. Incubation of red blood cell (RBC) membranes of healthy volunteers with hydrogen peroxide induces decreases in total ω3 (PUFAs) comparable to that found in depression (Peet et al., 1998).
Depression is characterized by activation of the inflammatory response system (IRS) with increased production of proinflammatory cytokines (Maes, 1997, Seidel et al., 1995, Sluzewska et al., 1995, Sluzewska et al., 1996). Proinflammatory cytokines and cytokine-induced reactive oxygen species (ROS) may increase lipid peroxidation (Maziere et al., 1994). Psychological stress, which accompanies severe depression, may increase lipid peroxidation (Hibbeln and Salem, 1995).
Vitamin E is another contributor to the radical-trapping antioxidant parameter of plasma (Wayner et al., 1987). Vitamin E is the major fat-soluble antioxidant, which is transported in the blood in lipids, e.g. triglycerides and low-density lipoprotein cholesterol (LDL-C) (Farrell, 1988, Gutteridge and Halliwell, 1994, Maes et al., 1996b, Cham et al., 1998). Vitamin E halts the chain reaction of PUFA peroxidation in membranes (Farrell, 1988, Packer and Fuchs, 1993). Lowered serum vitamin E levels occur during IRS activation (Louw et al., 1992).
The aims of the present study were to examine whether, (i) major depression is accompanied by lower serum vitamin E; and (ii) there are significant inverse relationships between lower serum vitamin E and signs of IRS activation, e.g. increased numbers of leukocytes and neutrophils.
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Subjects and methods
Twenty six healthy volunteers and 42 depressed patients participated. Controls were free of any medication for at least one month prior to the study. No one had ever been taking psychotropic drugs or was a regular drinker. Controls were excluded for past, present and family history of psychiatric disorders. The structured interview of the DSM-III-R (Spitzer et al., 1990) was used to make the diagnosis of major depression (APA, 1987). Severity of depression was measured with the 17 item Hamilton
Results
There were no significant differences (F=2.0, df=1/66, p=0.2) in age or male/female ratio between patients (mean=54.0±13.6 years; 12/30) and controls (mean=49.7±8.7 years; 11/15). There was no significant correlation (r=0.14, p=0.3) between vitamin E and age. There was no significant difference in vitamin E (F=0.7, df=1/64, p=0.6) between men and women. There was a significant positive correlation between serum vitamin E and LDL-C (r=0.51, p=0.00009), but not triglycerides (r=0.21, p=0.09). All
Discussion
We found that depressed patients have lower serum vitamin E concentrations than controls.
The causes have remained elusive. (1). Protein energy malnutrition may decrease the antioxidant status (Sauerwein et al., 1997). However, no protein energy malnutrition could be found in depression (Maes et al., 1991). Vitamin E deficiency due to inadequate dietary intake is not known to occur in humans (Tietz, 1990). No significant effects of diets on serum vitamin E were observed (Young, 1993). Moreover,
Acknowledgements
The research reported was supported in part by the Funds for Scientific Research, Vlaanderen, Belgium (FWO) and the Clinical Research Center Mental Health, (CRC-MH), Antwerp, Belgium; and the Staglin Investigator Award (NARSAD, USA) for Dr. M. Maes. The secretarial assistance of Mrs. M. Maes is greatly appreciated.
References (40)
- et al.
Oxygen-radical absorbance capacity assay for antioxidants
Free Radical Biol. Med.
(1993) - et al.
Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy
Am. J. Clin. Nutr.
(1995) - et al.
Marginal zinc deficiency lowers the lymphatic absorption of alpha-tocopherol in rats
J. Nutr.
(1998) - et al.
Anthropometric and biochemical assessment of the nutritional state in depression: evidence for lower visceral protein plasma levels in depression
J. Affect. Disord.
(1991) - et al.
Hypozincaemia in depression
J. Affect. Disord.
(1994) - et al.
Fatty acid composition in major depression: decreased ω3 fractions in cholesteryl esters and increased C20:4ω6/C20:5ω3 ratio in cholesteryl esters and phospholipids
J. Affect. Disord.
(1996) - et al.
Lowered omega 3 polyunsaturated fatty acids in serum phospholipids and cholertergl esters of depressed patients
Psychiatry Research
(1999) - et al.
Tumor necrosis factor enhances low density lipoprotein oxidative modification by monocytes and endothelial cells
FEBS Lett.
(1994) - et al.
Glutathione as a cerebral substrate in depressive behavior
Pharmacol. Biochem. Behav.
(1994) - et al.
Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients
Biol. Psychiatry
(1998)
Inflammatory mediators in children with protein-energy malnutrition
Am. J. Clin. Nutr.
Increased lipid peroxidation and decreased antioxidants in lungs of guinea pigs following an allergic pulmonary response
Toxicol. Appl. Pharmacol.
Indicators of immune activation in major depression
Psychiatr. Res.
Albumin decrement in depression and cholesterol decrement in mania
J. Affect. Disord.
Lower total serum protein, albumin, and beta- and gamma-globulin in major and treatment-resistant depression: effects of antidepressant treatments
Psychiatr. Res.
The relative contributions of vitamin E, urate, ascorbate and proteins to the total peroxyl radical-trapping antioxidant activity of human blood plasma
Biochim. Biophys. Acta
Diagnostic and Statistical Manual of Mental Disorders
Dietary zinc deficiency decreases plasma concentrations of vitamin E
Proc. Soc. Exp. Biol. Med.
Correlations between cholesterol, vitamin E and vitamin K1 in serum: paradoxical relationships to established epidemiological risk factors for cardiovascular disease
Clin. Chem.
The effects of alpha tocopherol supplementation on monocyte function. Decreased lipid oxidation, interleukin 1 beta secretion, and monocyte adhesion to endothelium
J Clin. Invest.
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