Международный эндокринологический журнал Том 21, №8, 2025

Поєднання депресії та метаболічного синдрому (МС) перетворилося на серйозну глобальну проблему у сфері охорони здоров’я. МС і депресія взаємно підвищують ризик виникнення один одного на 50–60 %. Сучасні дослідження доводять, що метаболічні порушення, які супроводжують коморбідні МС і депресивні розлади, проявляються хронічним запаленням низької інтенсивності (ХЗНІ), інсулінорезистентністю, лептинорезистентністю й артеріальною гіпертензією. Коморбідність депресії з ожирінням та МС пов’язана із ХЗНІ, яке характеризується зростанням рівня прозапальних цитокінів та С-реактивного протеїну. Ці метаболічні дисфункції здатні спричиняти зміни у структурі й функціонуванні центральної нервової системи, що, зрештою, стимулює розвиток великого депресивного розладу. Фармакотерапія депресії та МС часто виявляється неефективною через гетерогенність пацієнтів і обмеження наявних діагностичних підходів. Хоча серед основних факторів зниження когнітивних функцій зазвичай виділяють генетичну обумовленість, вікові зміни та спосіб життя, зростає розуміння важливості ролі біофакторів, особливо незамінних, у забезпеченні оптимального функціонування центральної нервової системи. Сучасні настанови рекомендують розглядати ω-3 поліненасичені жирні кислоти (ПНЖК) як перспективний терапевтичний варіант завдяки їхньому позитивному впливу на інсулінорезистентність, ХЗНІ, поліпшення настрою, а також зниження ризику розвитку великого депресивного розладу. ω-3 ПНЖК демонструють протизапальний вплив через регуляцію мембранного складу та оптимізацію ліпідного обміну; пригнічують утворення прозапальних простагландинів; сприяють зміщенню фізіологічного балансу у бік більш протизапального стану; зменшують ризик розвитку ожиріння, МС-асоційованих метаболічних розладів і хронічних запальних захворювань; позитивно впливають на маркери ХЗНІ, масу тіла та депресивні симптоми. Перспективними є зусилля щодо інтеграції стратегій використання ω-3 ПНЖК у клінічну практику, що може позитивно вплинути на результати лікування пацієнтів із депресією, МС, ожирінням або метаболічною дисрегуляцією. Метою огляду було проведення аналізу можливостей ω-3 ПНЖК у профілактиці/лікуванні метаболічного синдрому і депресії, а також аналізу нових тенденцій та напрямків майбутніх досліджень. Пошук проводився у базах даних Scopus, Science Direct (від Elsevier) і PubMed, включно з Medline. Використані ключові слова «метаболічний синдром», «депресія», «омега-3 поліненасичені жирні кислоти». Для виявлення результатів дослідження, які не вдалося знайти під час онлайн-пошуку, використовувався ручний пошук бібліографії публікацій.

The combination of depression and metabolic syndrome (MetS) has become a serious global health problem. MetS and depression mutually increase the risk of each other by 50–60 %. Current research indicates that metabolic disorders that accompany comorbid MetS and depressive disorders are manifested by low-grade chronic inflammation (LGCI), insulin resistance, leptin resistance, and hypertension. The comorbidity of depression with obesity and MetS is associated with LGCI, which is characterized by increased levels of proinflammatory cytokines and C-reactive protein. These metabolic dysfunctions can cause changes in the structure and functioning of the central nervous system, which ultimately stimulates the development of major depressive disorders. Pharmacotherapy for depression and MetS is often ineffective due to the heterogeneity of patients and the limitations of existing diagnostic approaches. Although genetic predisposition, age-related changes, and lifestyle are commonly identified as the main factors of cognitive decline, there is a growing understanding of the importance of the role of biological factors, especially essential ones, in ensuring optimal central nervous system functioning. Current guidelines recommend ω-3 polyunsaturated fatty acids (PUFAs) to be considered a promising therapeutic option due to their positive effects on the state of insulin resistance, LGCI, mood, and the risk of developing major depressive disorder. Ω-3 PUFAs demonstrate anti-inflammatory effects through regulation of membrane composition and optimization of lipid metabolism; inhibit the formation of pro-inflammatory prostaglandins; contribute to a shift in the physiological balance towards an anti-inflammatory state; reduce the risk of obesity, MetS-associated metabolic disorders, and chronic inflammatory diseases; have a positive effect on markers of LGCI, body mass, and depressive symptoms. Efforts to integrate strategies for the use of ω-3 PUFAs into clinical practice are promising, which may have a positive impact on the treatment outcomes of patients with depression, MetS, obesity, or metabolic dysregulation. The aim of the review was to analyze the potential of ω-3 PUFAs in the revention/treatment of metabolic syndrome and depression, as well as to analyze new trends and directions for future research. The search was conducted in Scopus, ScienceDirect (from Elsevier), and PubMed databases, including MEDLINE. The keywords used were “metabolic syndrome”, “depression”, and “omega-3 polyunsaturated fatty acids”. A manual search of the bibliography of publications was used to identify research results that could not be found during the online search.

метаболічний синдром; депресія; омега-3 поліненасичені жирні кислоти; огляд літератури

metabolic syndrome; depression; omega-3 polyunsaturated fatty acids; literature review

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