INSERM UMR 1178, Univ Paris Sud, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France.
INSERM U1061, University of Montpellier, FondaMental Foundation, Montpellier, France.
J Affect Disord. 2016 Jan 15;190:193-207. doi: 10.1016/j.jad.2015.09.027. Epub 2015 Oct 23.
Serotonin transporter-linked polymorphic region (5-HTTLPR) variants have been extensively studied in psychiatric disorders. Although gender effects have been reported, they have not been comprehensively reviewed. The aim of our study was to summarize literature findings on 5-HTTLPR and gender differences in affective disorders.
A systematic search of PubMed, ISI Web of Knowledge, and PsycINFO databases was performed for dates until January 2015. The included articles (n=78) analyzed the association between 5-HTTLPR and affective spectrum disorders, taking into account gender. The quality of each study was assessed through STROBE and CONSORT.
5-HTTLPR modulation of affective disorders varied by gender. The S allele (or SS genotype) seemed to be differently associated with an increased risk of depression, depressive symptoms, anxiety traits and symptoms, and symptoms of internalizing behavior among women and an increased risk of aggressiveness, conduct disorder and symptom counts of externalizing behavior among men. Moreover, the presence of stressful life events reinforced the association. Interestingly, these differences seemed to begin with adolescence and were not consistent among the elderly, suggesting a plausible role of hormonal fluctuations.
The review is limited by the small number of included papers, due to the paucity of information in the literature regarding 5-HTTLPR and gender.
5-HTTLPR variants may exert a differential modulation on a number of features depending on gender. Further studies are needed to more deeply investigate the effect of 5-HTTLPR×gender on the modulation of affective disorders.
血清素转运体基因（5-HTTLPR）多态性在精神疾病中已得到广泛研究。尽管已有研究报道了性别效应，但尚未进行全面综述。我们的研究旨在总结有关 5-HTTLPR 与情感障碍中性别差异的文献发现。
系统检索了 PubMed、ISI Web of Knowledge 和 PsycINFO 数据库，检索时间截至 2015 年 1 月。纳入的文章（n=78）分析了 5-HTTLPR 与情感谱障碍之间的关联，同时考虑了性别因素。通过 STROBE 和 CONSORT 评估了每项研究的质量。
5-HTTLPR 对情感障碍的调节作用因性别而异。S 等位基因（或 SS 基因型）似乎与女性抑郁、抑郁症状、焦虑特征和症状以及内化行为症状的风险增加以及男性的攻击性、品行障碍和外化行为症状计数的风险增加有关。此外，应激性生活事件的存在增强了这种关联。有趣的是，这些差异似乎始于青春期，在老年人中并不一致，这表明激素波动可能起作用。
由于文献中关于 5-HTTLPR 和性别方面的信息较少，本综述受到纳入研究数量较少的限制。
5-HTTLPR 变体可能根据性别对多种特征产生不同的调节作用。需要进一步的研究来更深入地探讨 5-HTTLPR×性别对情感障碍调节的影响。
