MHS, University of North Carolina at Chapel Hill, 137 E. Franklin Street, Suite 306, Chapel Hill, NC 27514.
Psychosom Med. 2014 Jan;76(1):12-9. doi: 10.1097/PSY.0000000000000009. Epub 2013 Dec 12.
To perform a systematic review and meta-analysis that quantitatively tests and summarizes the hypothesis that depression results in elevated oxidative stress and lower antioxidant levels.
We performed a meta-analysis of studies that reported an association between depression and oxidative stress and/or antioxidant status markers. PubMed and EMBASE databases were searched for articles published from January 1980 through December 2012. A random-effects model, weighted by inverse variance, was performed to pool standard deviation (Cohen's d) effect size estimates across studies for oxidative stress and antioxidant status measures, separately.
Twenty-three studies with 4980 participants were included in the meta-analysis. Depression was most commonly measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. A Cohen's d effect size of 0.55 (95% confidence interval = 0.47-0.63) was found for the association between depression and oxidative stress, indicating a roughly 0.55 of 1-standard-deviation increase in oxidative stress among individuals with depression compared with those without depression. The results of the studies displayed significant heterogeneity (I(2) = 80.0%, p < .001). A statistically significant effect was also observed for the association between depression and antioxidant status markers (Cohen's d = -0.24, 95% confidence interval = -0.33 to -0.15).
This meta-analysis observed an association between depression and oxidative stress and antioxidant status across many different studies. Differences in measures of depression and markers of oxidative stress and antioxidant status markers could account for the observed heterogeneity. These findings suggest that well-established associations between depression and poor heath outcomes may be mediated by high oxidative stress.
系统评价和荟萃分析定量检验和总结假说，即抑郁导致氧化应激升高和抗氧化剂水平降低。
我们对报道抑郁与氧化应激和/或抗氧化状态标志物之间存在关联的研究进行了荟萃分析。检索了 1980 年 1 月至 2012 年 12 月期间发表的 PubMed 和 EMBASE 数据库中的文章。采用随机效应模型，根据逆方差加权，对氧化应激和抗氧化状态指标的研究进行了荟萃分析，分别汇总了研究之间的标准偏差（Cohen's d）效应大小估计值。
共有 23 项研究，4980 名参与者纳入荟萃分析。抑郁最常使用《精神障碍诊断与统计手册》第四版标准进行测量。发现抑郁与氧化应激之间的关联具有 0.55 的 Cohen's d 效应大小（95%置信区间=0.47-0.63），这表明与无抑郁的个体相比，抑郁个体的氧化应激增加约 0.55 个标准差。研究结果显示存在显著的异质性（I²=80.0%，p<.001）。抑郁与抗氧化状态标志物之间的关联也具有统计学意义（Cohen's d=-0.24，95%置信区间=-0.33 至-0.15）。
本荟萃分析观察到许多不同研究中抑郁与氧化应激和抗氧化状态之间存在关联。抑郁和氧化应激及抗氧化状态标志物的测量差异可能解释了观察到的异质性。这些发现表明，抑郁与不良健康结局之间的明确关联可能是由高氧化应激介导的。
