Limits...
Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease.

van Hees NJ, Giltay EJ, Tielemans SM, Geleijnse JM, Puvill T, Janssen N, van der Does W - PLoS ONE (2015)

Bottom Line: The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005).However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychology, Leiden University, Leiden, The Netherlands.

ABSTRACT

Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters) are depleted in the diet and serum of CD patients with major depressive disorder.

Methods: In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus). Dietary intake was assessed using a 203-item food frequency questionnaire.

Results: Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005). However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.

Conclusions: Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

Show MeSH

Related in: MedlinePlus

Amino acid metabolism.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4401736&req=5

pone.0122619.g001: Amino acid metabolism.

Mentions: Several studies have revealed abnormalities in monoamine metabolism in patients with active CD [7,11,12]. Monoamine neurotransmitters and neuromodulators (i.e. serotonin, dopamine, norepinephrine, and epinephrine) play a role in the regulation of mood and cognitive functioning. Low monoamine function is associated with psychopathology such as anxiety and mood disorders [13]. Two studies investigating the effect of monoamine availability on psychiatric symptoms and disorders in active CD found an inverse correlation [14,15]. Several authors have hypothesized that malabsorption in active CD is linked to brain function and depression via reduced uptake of amino acids such as tryptophan and reduced production of monoamines such as serotonin [2,7,11,14,16]. One study investigated the effect of the introduction of the gluten-free diet in five adolescent CD patients with depression. They found lower pre-diet serum amino acid concentrations and institution of the gluten-free diet produced an improvement in psychiatric symptoms at three month follow-up, with a non-significant increase in tryptophan concentrations and a significant increase in the competing amino acids [17]. Another study, in 15 untreated and 12 treated children with CD and 12 controls, found significantly lower plasma tryptophan and tyrosine concentrations (62% and 21% respectively) compared to controls in treated CD patients at one year follow-up [7]. A study in seven adults with CD showed that gluten-free diet increased cerebrospinal fluid concentrations of major monoamine metabolites. After maintaining a gluten-free diet for a period ranging from 7 to 18 months the cerebrospinal fluid concentrations of the major serotonin metabolite 5-HIAA had a significant increase of 31% [11]. Studies following patients for a longer time have however not been performed and the question remains if concentrations of monoamine metabolites fully return to normal levels in treated CD. An informative overview of amino acid and monoamine metabolism can be found in Fig 1.


Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease.

van Hees NJ, Giltay EJ, Tielemans SM, Geleijnse JM, Puvill T, Janssen N, van der Does W - PLoS ONE (2015)

Amino acid metabolism.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401736&req=5

pone.0122619.g001: Amino acid metabolism.
Mentions: Several studies have revealed abnormalities in monoamine metabolism in patients with active CD [7,11,12]. Monoamine neurotransmitters and neuromodulators (i.e. serotonin, dopamine, norepinephrine, and epinephrine) play a role in the regulation of mood and cognitive functioning. Low monoamine function is associated with psychopathology such as anxiety and mood disorders [13]. Two studies investigating the effect of monoamine availability on psychiatric symptoms and disorders in active CD found an inverse correlation [14,15]. Several authors have hypothesized that malabsorption in active CD is linked to brain function and depression via reduced uptake of amino acids such as tryptophan and reduced production of monoamines such as serotonin [2,7,11,14,16]. One study investigated the effect of the introduction of the gluten-free diet in five adolescent CD patients with depression. They found lower pre-diet serum amino acid concentrations and institution of the gluten-free diet produced an improvement in psychiatric symptoms at three month follow-up, with a non-significant increase in tryptophan concentrations and a significant increase in the competing amino acids [17]. Another study, in 15 untreated and 12 treated children with CD and 12 controls, found significantly lower plasma tryptophan and tyrosine concentrations (62% and 21% respectively) compared to controls in treated CD patients at one year follow-up [7]. A study in seven adults with CD showed that gluten-free diet increased cerebrospinal fluid concentrations of major monoamine metabolites. After maintaining a gluten-free diet for a period ranging from 7 to 18 months the cerebrospinal fluid concentrations of the major serotonin metabolite 5-HIAA had a significant increase of 31% [11]. Studies following patients for a longer time have however not been performed and the question remains if concentrations of monoamine metabolites fully return to normal levels in treated CD. An informative overview of amino acid and monoamine metabolism can be found in Fig 1.

Bottom Line: The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005).However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychology, Leiden University, Leiden, The Netherlands.

ABSTRACT

Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters) are depleted in the diet and serum of CD patients with major depressive disorder.

Methods: In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus). Dietary intake was assessed using a 203-item food frequency questionnaire.

Results: Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005). However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.

Conclusions: Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

Show MeSH
Related in: MedlinePlus