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抗抑郁药的使用与白内障发生风险:一项系统评价和荟萃分析。

Antidepressants use and risk of cataract development: a systematic review and meta-analysis.

作者信息

Fu Yana, Dai Qi, Zhu Liwei, Wu Shuangqing

机构信息

The Eye Hospital of Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou City, 325027, Zhejiang Province, People's Republic of China.

Department of Ophthalmology, Hangzhou Red Cross Hospital, Hangzhou City, 310003, Zhejiang Province, People's Republic of China.

出版信息

BMC Ophthalmol. 2018 Feb 6;18(1):31. doi: 10.1186/s12886-018-0699-0.

Abstract

BACKGROUND

Epidemiological studies suggest that antidepressants use may increase the risk of cataract, but the results are inconclusive. We aimed to examine this association by performing a systematic review and meta-analysis.

METHODS

Relevant studies were identified by searching PubMed and Web of Science databases through June 2017. We included studies that reported risk estimates for the association between antidepressants use and cataract risk. A random-effects model was used to calculate the summary odds ratio (OR) with its 95% confidence interval (CI).

RESULTS

We identified seven studies of antidepressants use and risk of cataract involving 447,672 cases and 1,510,391 controls. Overall, the combined ORs (95% CIs) of cataract for selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenalin reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) were 1.12 (1.06-1.19), 1.13 (1.04-1.24), and 1.19 (1.11-1.28), respectively. A certain degree of heterogeneity was observed across studies (P < 0.001, I  = 92.2% for SSRIs, P = 0.026, I  = 67.5% for SNRIs, and P = 0.092, I  = 58.0% for TCAs).

CONCLUSION

This meta-analysis provides evidence of a significant positive association between antidepressants use and risk of cataract. Because of the heterogeneity and limited eligible studies, further prospective studies are warranted to confirm the preliminary findings of our study.

摘要

背景

流行病学研究表明,使用抗抑郁药可能会增加患白内障的风险,但结果尚无定论。我们旨在通过进行系统评价和荟萃分析来研究这种关联。

方法

通过检索截至2017年6月的PubMed和Web of Science数据库来确定相关研究。我们纳入了报告抗抑郁药使用与白内障风险之间关联的风险估计值的研究。采用随机效应模型计算汇总比值比(OR)及其95%置信区间(CI)。

结果

我们确定了7项关于抗抑郁药使用与白内障风险的研究,涉及447,672例病例和1,510,391例对照。总体而言,选择性5-羟色胺再摄取抑制剂(SSRIs)、5-羟色胺去甲肾上腺素再摄取抑制剂(SNRIs)和三环类抗抑郁药(TCAs)导致白内障的合并OR(95%CI)分别为1.12(1.06 - 1.19)、1.13(1.04 - 1.24)和1.19(1.11 - 1.28)。各研究间观察到一定程度的异质性(SSRIs:P < 0.001,I² = 92.2%;SNRIs:P = 0.026,I² = 67.5%;TCAs:P = 0.092,I² = 58.0%)。

结论

这项荟萃分析提供了使用抗抑郁药与白内障风险之间存在显著正相关的证据。由于存在异质性且符合条件的研究有限,有必要进行进一步的前瞻性研究以证实我们研究的初步结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c2e/5801704/afe98df8813a/12886_2018_699_Fig1_HTML.jpg

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