1 2nd Department of Neurosurgery, The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, China.
2 Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, China.
Eur J Prev Cardiol. 2018 May;25(7):706-716. doi: 10.1177/2047487318764158. Epub 2018 Mar 14.
Objectives The relationship of depressive symptoms and subclinical atherosclerosis remains controversial. We performed a systematic review and meta-analysis to evaluate the effect of depressive symptoms on the functional and structural markers of subclinical atherosclerosis as measured by carotid intima-media thickness (IMT), pulse wave velocity (PWV) and flow-mediated vasodilation (FMD). Methods A systematic literature search was performed electronically. Studies relating IMT, PWV or FMD to depressive symptoms were included. Standard/weighted mean differences (SMD/WMD) and corresponding 95% confidence intervals (95% CIs) were pooled in overall and subgroup analyses (age, sex, depression diagnosis, region, study design, site measured and sample size). Sensitivity analysis and publication bias were also conducted. Results Thirty-eight articles involving 5947 patients with depressive symptoms and 34,423 controls without depressive symptoms were included. Compared with controls without depressive symptoms, patients with depressive symptoms showed a significantly thicker IMT (SMD (95% CI) = 0.137 (0.047-0.227), p = 0.003), a higher PWV (SMD (95% CI) = 0.216 (0.139-0.293), p < 0.001) and a lower FMD (WMD (95% CI) = -2.554 (-3.709 to -1.399), p < 0.001). When analyzing subgroups with age and female ratio, all results were still significant ( p < 0.05) except IMT and FMD in age < 50 years subgroups ( p > 0.05). There was no statistical significance in sensitivity analysis and publication bias ( p > 0.05). Conclusions Depressive symptoms contributed toward subclinical atherosclerosis, and resulted in impaired functional and structural markers of subclinical atherosclerosis, which holds great promise in early prevention of cardiovascular disease.
目的 抑郁症状与亚临床动脉粥样硬化之间的关系仍存在争议。我们进行了一项系统综述和荟萃分析，以评估抑郁症状对亚临床动脉粥样硬化的功能和结构标志物（颈动脉内膜中层厚度（IMT）、脉搏波速度（PWV）和血流介导的血管扩张（FMD））的影响。
方法 系统地进行电子文献检索。纳入与 IMT、PWV 或 FMD 与抑郁症状相关的研究。在总体和亚组分析（年龄、性别、抑郁诊断、地区、研究设计、测量部位和样本量）中汇总了标准化/加权均数差（SMD/WMD）和相应的 95%置信区间（95%CI）。还进行了敏感性分析和发表偏倚。
结果 共纳入 38 篇文章，涉及 5947 例有抑郁症状的患者和 34423 例无抑郁症状的对照者。与无抑郁症状的对照者相比，有抑郁症状的患者 IMT 更厚（SMD（95%CI）=0.137（0.047-0.227），p=0.003），PWV 更高（SMD（95%CI）=0.216（0.139-0.293），p<0.001），FMD 更低（WMD（95%CI）=-2.554（-3.709 至-1.399），p<0.001）。在分析年龄和女性比例的亚组时，除了年龄<50 岁亚组的 IMT 和 FMD 外（p>0.05），所有结果仍然具有统计学意义（p<0.05）。敏感性分析和发表偏倚无统计学意义（p>0.05）。
结论 抑郁症状导致亚临床动脉粥样硬化，导致亚临床动脉粥样硬化的功能和结构标志物受损，这在心血管疾病的早期预防中具有很大的应用前景。
