Liu Tao, Zhong Shuming, Liao Xiaoxiao, Chen Jian, He Tingting, Lai Shunkai, Jia Yanbin
Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China; Guangzhou Brain Hospital, Guangzhou, China.
Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China.
PLoS One. 2015 Oct 7;10(10):e0138904. doi: 10.1371/journal.pone.0138904. eCollection 2015.
Studies have suggested that depression was accompanied by oxidative stress dysregulation, including abnormal total antioxidant capacity (TAC), antioxidants, free radicals, oxidative damage and autoimmune response products. This meta-analysis aims to analyse the clinical data quantitatively by comparing the oxidative stress markers between depressed patients and healthy controls.
A search was conducted to collect the studies that measured the oxidative stress markers in depressed patients. Studies were searched in Embase, Medline, PsychINFO, Science direct, CBMDisc, CNKI and VIP from 1990 to May 2015. Data were subjected to meta-analysis by using a random effects model for examining the effect sizes of the results. Bias assessments, heterogeneity assessments and sensitivity analyses were also conducted.
115 articles met the inclusion criteria. Lower TAC was noted in acute episodes (AEs) of depressed patients (p<0.05). Antioxidants, including serum paraoxonase, uric acid, albumin, high-density lipoprotein cholesterol and zinc levels were lower than controls (p<0.05); the serum uric acid, albumin and vitamin C levels were increased after antidepressant therapy (p<0.05). Oxidative damage products, including red blood cell (RBC) malondialdehyde (MDA), serum MDA and 8-F2-isoprostanes levels were higher than controls (p<0.05). After antidepressant medication, RBC and serum MDA levels were decreased (p<0.05). Moreover, serum peroxide in free radicals levels were higher than controls (p<0.05). There were no differences between the depressed patients and controls for other oxidative stress markers.
This meta-analysis supports the facts that the serum TAC, paraoxonase and antioxidant levels are lower, and the serum free radical and oxidative damage product levels are higher than controls in depressed patients. Meanwhile, the antioxidant levels are increased and the oxidative damage product levels are decreased after antidepressant medication. The pathophysiological relationships between oxidative stress and depression, and the potential benefits of antioxidant supplementation deserve further research.
研究表明，抑郁症伴有氧化应激失调，包括总抗氧化能力（TAC）异常、抗氧化剂、自由基、氧化损伤和自身免疫反应产物。本荟萃分析旨在通过比较抑郁症患者与健康对照者之间的氧化应激标志物来定量分析临床数据。
进行检索以收集测量抑郁症患者氧化应激标志物的研究。在1990年至2015年5月期间，在Embase、Medline、PsychINFO、Science direct、CBMDisc、CNKI和VIP中检索研究。使用随机效应模型对数据进行荟萃分析，以检验结果的效应大小。还进行了偏倚评估、异质性评估和敏感性分析。
115篇文章符合纳入标准。抑郁症患者急性发作期（AEs）的TAC较低（p<0.05）。抗氧化剂，包括血清对氧磷酶、尿酸、白蛋白、高密度脂蛋白胆固醇和锌水平低于对照组（p<0.05）；抗抑郁治疗后血清尿酸、白蛋白和维生素C水平升高（p<0.05）。氧化损伤产物，包括红细胞（RBC）丙二醛（MDA）、血清MDA和8-F2-异前列腺素水平高于对照组（p<0.05）。抗抑郁药物治疗后，RBC和血清MDA水平降低（p<0.05）。此外，自由基水平中的血清过氧化物高于对照组（p<0.05）。抑郁症患者与对照组在其他氧化应激标志物方面无差异。
本荟萃分析支持以下事实：抑郁症患者的血清TAC、对氧磷酶和抗氧化剂水平较低，血清自由基和氧化损伤产物水平高于对照组。同时，抗抑郁药物治疗后抗氧化剂水平升高，氧化损伤产物水平降低。氧化应激与抑郁症之间的病理生理关系以及补充抗氧化剂的潜在益处值得进一步研究。
