マルチビタミンのいんちき:臨床的有益性ありません

米国人はマルチビタミン好きだからなぁ

日本を含む5ヶ国200万名以上のデータベース由来の関連性調査
無駄なマルチビタミンやサプリメント摂取をやめ、有益性確立している、「健康食」　「運動」「禁煙」、血圧コントロール、不健康なコレステロール値正常化をと筆者



Multivitamins do not promote cardiovascular health
Circulation: Cardiovascular Quality and Outcomes Journal Report
https://newsroom.heart.org/news/multivitamins-do-not-promote-cardiovascular-health


DALLAS, July 10, 2018 – Taking multivitamin and mineral supplements does not prevent heart attacks, strokes or cardiovascular death, according to a new analysis of 18 studies published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

“We meticulously evaluated the body of scientific evidence,” said study lead author Joonseok Kim, M.D., assistant professor of cardiology in the Department of Medicine at the University of Alabama at Birmingham. “We found no clinical benefit of multivitamin and mineral use to prevent heart attacks, strokes or cardiovascular death.”


【オリジナル論文】Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease
A Systematic Review and Meta-Analysis
Joonseok Kim, et. al.
https://doi.org/10.1161/CIRCOUTCOMES.117.004224
Circulation: Cardiovascular Quality and Outcomes. 2018;11:e004224
Originally published July 10, 2018

【エディトリアル】
Multivitamins Do Not Reduce Cardiovascular Disease and Mortality and Should Not Be Taken for This Purpose
How Do We Know That?
Circulation: Cardiovascular Quality and Outcomes. 2018;11:e004886, originally published July 10, 2018

うつとエピジェネティック変化(DNAメチル化）

うつと、エピジェネティック変化であるDNAメチル化signatureの関連性

遺伝と環境によるエピジェネティック変化として代表的な CpG siteのメチル化とうつの関連性明確化


DNA Methylation Signatures of Depressive Symptoms in Middle-aged and Elderly Persons
Meta-analysis of Multiethnic Epigenome-wide Studies
JAMA Psychiatry. Published online July 11, 2018. doi:10.1001/jamapsychiatry.2018.1725


民族横断的 epigenome-wide association studies (EWAS)メタ解析
framework of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortiumとして施行

discovery cohortは、 7948名（女性 4104, 51.6%)、平均年齢 65.4, SD 5.8歳
replication cohortは、 3308 名 (女性 2456 [74.2%] ) 、平均年齢 60.3, SD 6.4歳


EWASにて、うつ症状と関連有意の3つのCpG siteメチル化同定

• cg04987734 (P = 1.57 × 10−08; n = 11 256
• CDC42BPB gene), cg12325605 (P = 5.24 × 10−09; n = 11 256; ARHGEF3 gene)
• intergenic CpG site cg14023999 (P = 5.99 × 10−08; n = 11 256; chromosome = 15q26.1)

脳内（基底核）の CDC42BPB gene(effect, 0.14; P = 2.7 × 10−03) と線維芽細胞 ARHGEF3 (effect, −0.48; P = 9.8 × 10−04) の予測発現性は大うつと相関

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脳内（基底核）メチル化推定方法は以下記載（よく分からんが・・・）
Blood and Brain Correlation

We checked the correlation between methylation in blood and various brain regions at the 3 identified sites using a web-based tool (BECon18) and a blood-brain DNA methylation comparison tool (http://epigenetics.essex.ac.uk/bloodbrain/).
BECon showed correlation between blood and brain DNA methylation, for example, methylation at cg04987734 in the CDC42BPB gene was highly correlated (r = 0.81) between blood and the Brodmann area 7 that spans the medial and lateral walls of the parietal cortex (eFigure 6 in the Supplement)

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うつ病の遺伝的関与は中程度で、heritabilityとしては40-50%で、高齢うつではわずか
心理社会的ストレッサーが炎症誘発性サイトカイン増加をもたらし、うつ発症ということも示唆されている。DNAメチル化のようなエピジェネティックなメカニズムと心理社会的ストレッサーとの関連性をうまく説明できたら・・・