Darrow Sabrina M, Verhoeven Josine E, Révész Dóra, Lindqvist Daniel, Penninx Brenda W J H, Delucchi Kevin L, Wolkowitz Owen M, Mathews Carol A
From the Department of Psychiatry (Darrow, Lindqvist, Delucchi, Wolkowitz, Mathews), University of California, San Francisco; Department of Psychiatry (Verhoeven, Révész, Penninx) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; and Department of Clinical Sciences (Lindqvist), Section for Psychiatry, Lund University, Lund, Sweden.
Psychosom Med. 2016 Sep;78(7):776-87. doi: 10.1097/PSY.0000000000000356.
This study examined the relationship between leukocyte telomere length (LTL), a marker of cell aging, and psychiatric disorders in adults compared with controls using meta-analytic methods.
Data were abstracted from studies examining the relationship between LTL and adult psychiatric disorders. In addition to an overall estimate of effect size, subgroup analyses and meta-regression were performed to examine whether covariates (including psychiatric diagnoses) moderated the estimate.
A significant overall effect size showing LTL shortening was found across all psychiatric disorders (Hedge g = -0.50, p < .001). Subgroup analyses did not demonstrate significant differences in effect size based on individual covariates (psychiatric disorder, sex, age, or assay method). The meta-regression indicated that although type of disorder and, likely, age moderate the overall effect size, the heterogeneity between studies could not be explained by a model that included these variables as well as sex and assay method. Although not significantly different, posttraumatic stress disorder, anxiety disorders, and depressive disorders had comparatively larger effect sizes (-1.27, -0.53, and -0.55), and psychotic and bipolar disorders had comparatively smaller ones (-0.23 and -0.26).
We observed a robust effect size of LTL shortening for psychiatric disorders as a whole compared with controls. The results were less straightforward regarding relative differences in the strength of this association by specific disorder. Future studies should focus on mechanisms explaining accelerated cell aging with psychiatric illness, defining directions (if any) of causality and elucidating possible differences in this association between disorders.
本研究采用荟萃分析方法,比较了成年人中细胞衰老标志物白细胞端粒长度(LTL)与精神障碍之间的关系,并与对照组进行了对比。
从研究LTL与成人精神障碍关系的研究中提取数据。除了对效应量进行总体估计外,还进行了亚组分析和元回归分析,以检验协变量(包括精神疾病诊断)是否调节了估计值。
在所有精神障碍中均发现了显著的总体效应量,表明LTL缩短(Hedge g = -0.50,p <.001)。亚组分析未显示基于个体协变量(精神障碍、性别、年龄或检测方法)的效应量存在显著差异。元回归分析表明,尽管疾病类型以及年龄可能会调节总体效应量,但包含这些变量以及性别和检测方法的模型无法解释研究之间的异质性。尽管差异不显著,但创伤后应激障碍、焦虑症和抑郁症的效应量相对较大(-1.27、-0.53和-0.55),而精神病性障碍和双相情感障碍的效应量相对较小(-0.23和-0.26)。
与对照组相比,我们观察到精神障碍患者的LTL缩短效应量显著。关于特定疾病在这种关联强度上的相对差异,结果并不那么直接。未来的研究应关注解释精神疾病导致细胞衰老加速的机制,确定因果关系的方向(如果有的话),并阐明不同疾病之间这种关联的可能差异。