Omega-3 fatty acids in bipolar patients with a low omega-3 index and reduced heart rate variability: the "BIPO-3" trial.

Bipolar disorders Heart rate variability, omega-3 index Omega-3 fatty acids Randomised controlled trial

Journal

International journal of bipolar disorders
ISSN: 2194-7511
Titre abrégé: Int J Bipolar Disord
Pays: Germany
ID NLM: 101622983

Informations de publication

Date de publication:
01 Apr 2022
Historique:
received: 23 08 2021
accepted: 31 01 2022
entrez: 1 4 2022
pubmed: 2 4 2022
medline: 2 4 2022
Statut: epublish

Résumé

Research suggests that a low omega-3 index may contribute to the low heart rate variability and the increased risk of cardiovascular morbidity and mortality in bipolar disorders. However, so far, no intervention trial with EPA and DHA has been conducted in bipolar patients attempting to increase their heart rate variability. 119 patients with bipolar disorder according to DSM-IV were screened, with 55 euthymic bipolar patients-owing to inclusion criteria (e.g. low omega-3 index (< 6%), SDNN < 60 ms.)-being enrolled in a randomized, double-blind, 12-week parallel study design with omega-3 fatty acids (4 capsules of 530 mg EPA, 150 mg DHA) or corn oil as a placebo, in addition to usual treatment. Heart rate variability as well as the omega-3 index were measured at baseline and at the endpoint of the study. A total of 42 patients (omega-3: n = 23, corn oil: n = 19) successfully completed the study after 12 weeks. There was a significant increase in the omega-3 index (value at endpoint minus value at baseline) in the omega-3 group compared to the corn oil group (p < 0.0001). However, there was no significant difference in the change of the SDNN (value at endpoint minus value at baseline) between the treatment groups (p = 0.22). In addition, no correlation between changes in SDNN and change in the omega-3 index could be detected in the omega-3 group (correlation coefficient = 0.02, p = 0.94) or the corn oil group (correlation coefficient =  - 0.11, p = 0.91). Similarly, no significant differences between corn oil and omega-3 group regarding the change of LF (p = 0.19), HF (p = 0.34) and LF/HF ratio (p = 0.84) could be demonstrated. In our randomized, controlled intervention trial in euthymic bipolar patients with a low omega-3 index and reduced heart rate variability no significant effect of omega-3 fatty acids on SDNN or frequency-domain measures HF, LF and LF/HF ratio could be detected. Possible reasons include, among others, the effect of psychotropic medication present in our trial and/or the genetics of bipolar disorder itself. Further research is needed to test these hypotheses. Trial registration ClinicalTrials.gov, NCT00891826. Registered 01 May 2009-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT00891826.

Sections du résumé

BACKGROUND BACKGROUND
Research suggests that a low omega-3 index may contribute to the low heart rate variability and the increased risk of cardiovascular morbidity and mortality in bipolar disorders. However, so far, no intervention trial with EPA and DHA has been conducted in bipolar patients attempting to increase their heart rate variability.
METHODS METHODS
119 patients with bipolar disorder according to DSM-IV were screened, with 55 euthymic bipolar patients-owing to inclusion criteria (e.g. low omega-3 index (< 6%), SDNN < 60 ms.)-being enrolled in a randomized, double-blind, 12-week parallel study design with omega-3 fatty acids (4 capsules of 530 mg EPA, 150 mg DHA) or corn oil as a placebo, in addition to usual treatment. Heart rate variability as well as the omega-3 index were measured at baseline and at the endpoint of the study.
RESULTS RESULTS
A total of 42 patients (omega-3: n = 23, corn oil: n = 19) successfully completed the study after 12 weeks. There was a significant increase in the omega-3 index (value at endpoint minus value at baseline) in the omega-3 group compared to the corn oil group (p < 0.0001). However, there was no significant difference in the change of the SDNN (value at endpoint minus value at baseline) between the treatment groups (p = 0.22). In addition, no correlation between changes in SDNN and change in the omega-3 index could be detected in the omega-3 group (correlation coefficient = 0.02, p = 0.94) or the corn oil group (correlation coefficient =  - 0.11, p = 0.91). Similarly, no significant differences between corn oil and omega-3 group regarding the change of LF (p = 0.19), HF (p = 0.34) and LF/HF ratio (p = 0.84) could be demonstrated.
CONCLUSIONS CONCLUSIONS
In our randomized, controlled intervention trial in euthymic bipolar patients with a low omega-3 index and reduced heart rate variability no significant effect of omega-3 fatty acids on SDNN or frequency-domain measures HF, LF and LF/HF ratio could be detected. Possible reasons include, among others, the effect of psychotropic medication present in our trial and/or the genetics of bipolar disorder itself. Further research is needed to test these hypotheses. Trial registration ClinicalTrials.gov, NCT00891826. Registered 01 May 2009-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT00891826.

Identifiants

pubmed: 35362878
doi: 10.1186/s40345-022-00253-9
pii: 10.1186/s40345-022-00253-9
pmc: PMC8975918
doi:

Banques de données

ClinicalTrials.gov
['NCT00891826']

Types de publication

Journal Article

Langues

eng

Pagination

9

Informations de copyright

© 2022. The Author(s).

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Auteurs

Michael Berger (M)

Zeughaus Practice, Zurich, Switzerland.

Florian Seemüller (F)

Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.
Department of Psychiatry, Psychosomatic and Psychotherapy, Kbo-Lech-Mangfall-Clinic Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany.

Alessandra Voggt (A)

St. Joseph Krankenhaus, Klinik Für Seelische Gesundheit Im Kindes- Und Jugendalter, Berlin, Germany.

Michael Obermeier (M)

Gesellschaft Für Therapieforschung mbH, Munich, Germany.

Franca Kirchberg (F)

Division of Metabolic and Nutritional Medicine, Dr. Von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.

Anja Löw (A)

Department of Internal Medicine I - Cardiology, Ludwig-Maximilians-Universität München, Munich, Germany.

Michael Riedel (M)

Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.
Marion Von Tessin Memory-Zentrum gGmbH, Munich, Germany.

Clemens von Schacky (C)

Department of Preventive Cardiology, Ludwig- Maximilians-Universität München, Munich, Germany.
Omegametrix, GmbH, Planegg, Germany.

Emanuel Severus (E)

Department of Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany. Emanuel.Severus@uniklinikum-dresden.de.

Classifications MeSH