Overview of metabolomic aspects in postpartum depression

Differential Psychopathology Associations Found for Docosahexaenoic Acid versus Arachidonic Acid Oxylipins of the Cytochrome P450 Pathway in Anorexia Nervosa

Anorexia nervosa (AN) is one of the deadliest disorders in psychiatry. AN patients tend to avoid high-fat and high-calorie foods to maintain a pathologically low body weight. High-fat foods are major sources of polyunsaturated fatty acids (PUFAs), lipids that are crucial for health and brain development. PUFAs can be categorized into different omega classes (n-3, n-6) or into essential (ALA, LA) versus nonessential PUFAs (EPA, DHA, ARA). PUFAs are metabolized by Cytochrome P450 (CYP450) enzymes into bioactive oxylipins with inflammation-resolving properties termed epoxy-fatty acids (EpFAs). EpFAs are further hydrolyzed into pro-inflammatory diol-fatty acids (DiHFAs) by soluble epoxide hydrolase (sEH), the protein product of an AN risk gene, EPHX2 . Using a meal challenge study protocol, EpFA and DiHFA oxylipins and sEH were analyzed in age-matched AN and healthy women to determine if sEH-associated oxylipins affect AN risk and psychopathology. At the fasting timepoint, half of the oxylipins were lower in AN compared to controls (all p<0.050). After eating, all but one EpFAs increased in AN (p=0.091 to 0.697) whereas all EpFAs decreased in controls (p=0.0008 to 0.462). By contrast, essential PUFA-derived DiHFAs significantly increased, whereas nonessential PUFA-derived DiHFAs significantly decreased in both groups. DiHFA oxylipins associated with AN psychopathology displayed a PUFA-dependent directionally opposite pattern: n-3 DHA-derived DiHFAs (DiHDPEs) were associated with lower severity in eating disorder risk, global psychological maladjustment, shape and restraint concerns, and global Eating Disorder Examination score. By contrast, n-6 ARA-derived DiHFAs (DiHETrEs) were associated with more severe emotional dysregulation, bulimia, interoceptive deficits, asceticism, and overcontrol scores. On the other hand, EpFA oxylipins were not significantly associated with AN psychopathology. This study confirms lipid metabolic dysregulation as a risk factor for AN. CYP450 oxylipins associated with AN risk and symptoms are sEH- and PUFA class-dependent. Our findings reveal that gene-diet interactions contribute to metabolic dysregulation in AN, highlighting a need for additional research to develop precision medicine for AN management.

Blood metabolomic and postpartum depression: a mendelian randomization study

BACKGROUND

Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent research suggests a metabolic component to the disorder. This study aims to investigate the causal relationship between blood metabolites and postpartum depression using mendelian randomization (MR).

METHODS

This study used a bi-directional MR framework to investigate the causal relationship between 1,400 metabolic biomarkers and postpartum depression. We used two specific genome-wide association studies datasets: one with single nucleotide polymorphisms data from mothers diagnosed with postpartum depression and another with blood metabolite data, both of which focused on people of European ancestry. Genetic variants were chosen as instrumental variables from both datasets using strict criteria to improve the robustness of the MR analysis. The combination of these datasets enabled a thorough examination of genetic influences on metabolic profiles associated with postpartum depression. Statistical analyses were conducted using techniques such as inverse variance weighting, weighted median, and model-based estimation, which enabled rigorous causal inference from the observed associations. postpartum depression was defined using endpoint definitions approved by the FinnGen study's clinical expert groups, which included leading experts in their respective medical fields.

RESULTS

The MR analysis identified seven metabolites that could be linked to postpartum depression. Out of these, one metabolite was found to be protective, while six were associated with an increased risk of developing the condition. The results were consistent across multiple MR methods, indicating a significant correlation.

CONCLUSIONS

This study emphasizes the potential of metabolomics for understanding postpartum depression. The discovery of specific metabolites associated with the condition sheds new insights on its pathophysiology and opens up possibilities for future research into targeted treatment strategies.

Mendelian randomization analyses for the causal relationship between early age at first sexual intercourse, early age at first live birth, and postpartum depression in pregnant women

Introduction

There are insufficient epidemiological studies on the impact of age at first sexual intercourse (AFS) and age at first live birth (AFB) on postpartum depression (PPD) in pregnant women, and the conclusions of these studies are inconsistent.

Methods

We performed a Mendelian randomization (MR) study to determine the causal relationship between AFS or AFB and the risk of PPD. The summary data were extracted from genome-wide association study (GWAS) summary datasets. We selected the instrumental variables according to the P value of exposure-related single nucleotide polymorphisms (P<5 ×10-9 for AFS and P<5 ×10-8 for AFB) and estimated the linkage disequilibrium using the clump parameter (10,000 kb, r2 < 0.001). Single nucleotide polymorphisms were considered instrumental variables that were significantly associated with exposure factors without linkage disequilibrium. The F-statistics of the instrumental variables should all be larger than 10. A random-effects model of IVW was constructed as the main method in our study.

Results and discussion

MR studies based on GWAS data revealed that both AFS (OR = 0.4, P <0.001) and AFB (OR = 0.38, P <0.001) were negatively correlated with the risk of PPD. Early AFS and early AFB should be studied as possible risk factors for PPD in the future. Public health departments should attach importance to sex education for young girls. The results of our TSMR should be verified by high-quality prospective epidemiological studies in the future.

Heart Rate Variability Measurement Can Be a Point-of-Care Sensing Tool for Screening Postpartum Depression: Differentiation from Adjustment Disorder

Postpartum depression (PPD) is a serious mental health issue among women after childbirth, and screening systems that incorporate questionnaires have been utilized to screen for PPD. These questionnaires are sensitive but less specific, and the additional use of objective measures could be helpful. The present study aimed to verify the usefulness of a measure of autonomic function, heart rate variability (HRV), which has been reported to be dysregulated in people with depression. Among 935 women who had experienced childbirth and completed the Edinburgh Postnatal Depression Scale (EPDS), HRV was measured in EPDS-positive women (n = 45) 1 to 4 weeks after childbirth using a wearable device. The measurement was based on a three-behavioral-state paradigm with a 5 min duration, consisting of rest (Rest), task load (Task), and rest-after-task (After) states, and the low-frequency power (LF), the high-frequency power (HF), and their ratio (LF/HF) were calculated. Among the women included in this study, 12 were diagnosed with PPD and 33 were diagnosed with adjustment disorder (AJD). Women with PPD showed a lack of adequate HRV regulation in response to the task load, accompanying a high LF/HF score in the Rest state. On the other hand, women with AJD exhibited high HF and reduced LF/HF during the After state. A linear discriminant analysis using HRV indices and heart rate (HR) revealed that both the differentiation of PPD and AJD patients from the controls and that of PPD patients from AJD patients were possible. The sensitivity and specificity for PPD vs. AJD were 75.0% and 90.9%, respectively. Using this paradigm, an HRV measurement revealed the characteristic autonomic profiles of PPD and AJD, suggesting that it may serve as a point-of-care sensing tool in PPD screening systems.

Treatment of Depression with Acupuncture Based on Pathophysiological Mechanism

Depression is a prevalent mental disorder and has a profound impact on an individual's psychological and physical well-being. It is characterized by a persistently depressed mood, loss of interest, energy loss, and cognitive dysfunction. In recent years, more and more people have changed to mental diseases, such as depression, anxiety, mania and so on. In the incidence of depression, covering all ages, but still mainly young and middle-aged women. Traditional treatments for depression mainly rely on medication and psychotherapy, but these methods are not effective for all patients and are often accompanied by certain side effects. Therefore, finding safe and effective alternative or adjuvant treatments has become a priority. Here we highlight the research progress of acupuncture in the treatment of depression and to explore the mechanism of acupuncture in the treatment of depression. Acupuncture treatment of depression is an ancient and effective method, the mechanism involves multiple biological pathways, for example, by regulating neurotransmitter levels, regulating the neuroendocrine axis, improving neuroplasticity, anti-inflammatory and other effects, improving emotional state and play an antidepressant role. To provide evidence to support the widespread use of acupuncture in clinical practice. We hope to provide new treatment ideas and methods for patients with depression, and even reduce the incidence of depression.