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分裂情感性障碍与代谢综合征:与精神分裂症及其他非情感性精神病的荟萃分析比较

Schizoaffective disorder and metabolic syndrome: A meta-analytic comparison with schizophrenia and other non-affective psychoses.

作者信息

Bartoli Francesco, Crocamo Cristina, Caslini Manuela, Clerici Massimo, Carrà Giuseppe

机构信息

Department of Surgery and Translational Medicine, University of Milano Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.

Department of Surgery and Translational Medicine, University of Milano Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.

出版信息

J Psychiatr Res. 2015 Jul-Aug;66-67:127-34. doi: 10.1016/j.jpsychires.2015.04.028. Epub 2015 May 11.

Abstract

People with psychotic disorders, including schizophrenia (SCZ), schizoaffective disorder (SD), or other non-affective psychoses (ONAP), have a higher risk of metabolic syndrome (MetS) than general population. However, previous meta-analyses failed to explore if people with SD are more likely to suffer from MetS than SCZ and ONAP. We carried out a systematic review and meta-analysis comparing rates of MetS in SD with those in SCZ or ONAP. We searched main electronic databases for relevant articles published up to January 2015, and for unpublished data, contacting corresponding authors, to minimize selective reporting bias. Odds ratios (ORs) based on random effects models, with 95% confidence intervals (CIs), and heterogeneity (I(2)), were estimated. We performed leave-one-out, quality-based, and subgroups analyses to check findings validity. Testing for publication bias, Egger's test estimates were reported. We included 7616 individuals (1632 with SD and 5984 with SCZ/ONAP) from 30 independent samples. SD, as compared with SCZ/ONAP, had a random-effect pooled OR (95%CI) for MetS of 1.41 (1.23-1.61; p < 0.001; I(2) = 5%). No risk of publication bias was found (p = 0.85). Leave-one-out, sensitivity, and subgroups analyses confirmed the association. To our knowledge, this is the first meta-analysis comparing MetS comorbidity between individuals with SD and those with SCZ or ONAP. SD subjects are more likely to suffer from MetS, with consistent findings across the studies included. However, the role of explanatory factors of this association, and the relative contribution of MetS subcomponents, deserve further research.

摘要

患有精神分裂症(SCZ)、分裂情感性障碍(SD)或其他非情感性精神病(ONAP)等精神障碍的人群,患代谢综合征(MetS)的风险高于普通人群。然而,以往的荟萃分析未能探究患有SD的人群是否比患有SCZ和ONAP的人群更易患MetS。我们进行了一项系统评价和荟萃分析,比较SD患者与SCZ或ONAP患者的MetS发生率。我们检索了主要电子数据库,查找截至2015年1月发表的相关文章,并联系通讯作者获取未发表的数据,以尽量减少选择性报告偏倚。基于随机效应模型估计比值比(OR)、95%置信区间(CI)和异质性(I(2))。我们进行了逐一剔除分析、基于质量的分析和亚组分析,以检验研究结果的有效性。报告了用于检验发表偏倚的Egger检验估计值。我们纳入了来自30个独立样本的7616名个体(1632名患有SD,5984名患有SCZ/ONAP)。与SCZ/ONAP相比,SD患者患MetS的随机效应合并OR(95%CI)为1.41(1.23 - 1.61;p < 0.001;I(2) = 5%)。未发现发表偏倚风险(p = 0.85)。逐一剔除分析、敏感性分析和亚组分析均证实了这种关联。据我们所知,这是第一项比较SD患者与SCZ或ONAP患者之间MetS合并症的荟萃分析。SD患者更易患MetS,纳入的各项研究结果一致。然而,这种关联的解释因素的作用以及MetS各亚组分的相对贡献,值得进一步研究。

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