抑郁症中的锌：一项荟萃分析。

Zinc in depression: a meta-analysis.

机构信息

Neuropsychopharmacology Research Group, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.

出版信息

Biol Psychiatry. 2013 Dec 15;74(12):872-8. doi: 10.1016/j.biopsych.2013.05.008. Epub 2013 Jun 24.

DOI:10.1016/j.biopsych.2013.05.008

PMID:23806573

Abstract

BACKGROUND

Zinc is an essential micronutrient with diverse biological roles in cell growth, apoptosis and metabolism, and in the regulation of endocrine, immune, and neuronal functions implicated in the pathophysiology of depression. This study sought to quantitatively summarize the clinical data comparing peripheral blood zinc concentrations between depressed and nondepressed subjects.

METHODS

PubMed, Cumulated Index to Nursing and Allied Health Literature, and PsycINFO were searched for original peer-reviewed studies (to June 2012) measuring zinc concentrations in serum or plasma from depressed subjects (identified by either screening or clinical criteria) and nondepressed control subjects. Mean (±SD) zinc concentrations were extracted, combined quantitatively in random-effects meta-analysis, and summarized as a weighted mean difference (WMD).

RESULTS

Seventeen studies, measuring peripheral blood zinc concentrations in 1643 depressed and 804 control subjects, were included. Zinc concentrations were approximately -1.85 µmol/L lower in depressed subjects than control subjects (95% confidence interval: [CI]: -2.51 to -1.19 µmol/L, Z17 = 5.45, p < .00001). Heterogeneity was detected (χ(2)17 = 142.81, p < .00001, I(2) = 88%) and explored; in studies that quantified depressive symptoms, greater depression severity was associated with greater relative zinc deficiency (B = -1.503, t9 = -2.82, p = .026). Effect sizes were numerically larger in studies of inpatients (WMD -2.543, 95% CI: -3.522 to -1.564, Z9 = 5.09, p < .0001) versus community samples (WMD -.943, 95% CI: -1.563 to -.323, Z7 = 2.98, p = .003) and in studies of higher methodological quality (WMD -2.354, 95% CI: -2.901 to -1.807, Z7 = 8.43, p < .0001).

CONCLUSIONS

Depression is associated with a lower concentration of zinc in peripheral blood. The pathophysiological relationships between zinc status and depression, and the potential benefits of zinc supplementation in depressed patients, warrant further investigation.

摘要

背景

锌是一种必需的微量元素，在细胞生长、凋亡和代谢过程中具有多种生物学作用，并在调节内分泌、免疫和神经元功能方面发挥作用，这些功能与抑郁症的病理生理学有关。本研究旨在定量总结比较抑郁患者和非抑郁患者外周血锌浓度的临床数据。

方法

检索 PubMed、Cumulated Index to Nursing and Allied Health Literature 和 PsycINFO，查找截至 2012 年 6 月测量抑郁患者（通过筛查或临床标准确定）和非抑郁对照者血清或血浆中锌浓度的原始同行评审研究。提取平均（±SD）锌浓度，进行随机效应荟萃分析定量合并，并总结为加权均数差（WMD）。

结果

共纳入 17 项研究，测量了 1643 例抑郁患者和 804 例对照者的外周血锌浓度。抑郁患者的锌浓度比对照者低约-1.85µmol/L（95%置信区间：[CI]：-2.51 至-1.19µmol/L，Z17=5.45，p<0.00001）。检测到异质性（χ(2)17=142.81，p<0.00001，I(2)=88%）并进行了探讨；在量化抑郁症状的研究中，抑郁严重程度与相对缺锌程度呈正相关（B=-1.503，t9=-2.82，p=0.026）。在住院患者研究中（WMD -2.543，95%CI：-3.522 至-1.564，Z9=5.09，p<0.0001）与社区样本研究中（WMD -0.943，95%CI：-1.563 至-0.323，Z7=2.98，p=0.003）和方法学质量较高的研究中（WMD -2.354，95%CI：-2.901 至-1.807，Z7=8.43，p<0.0001），效应大小数值较大。