Department of Endocrinology and Metabolism, Institute of Endocrinology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China.
First Affiliated Hospital of Sun Yat-sen University, Department of Hepatobiliary Surgery, Guangzhou, China.
Transl Psychiatry. 2018 Oct 30;8(1):239. doi: 10.1038/s41398-018-0283-7.
The objective of this study was to evaluate the relationship between subclinical hypothyroidism (SCH) and depression. We also analysed the effect of levothyroxine (L-T4) on depression in SCH patients. We found an insignificant difference for the composite endpoint: standard mean difference (SMD) of 0.23 (95% confidence interval (CI) -0.03, 0.48, P = 0.08, I = 73.6%). The odds ratio (OR) for depressive patients was 1.75 (95% CI 0.97, 3.17 P = 0.064, I = 64.6%). Furthermore, sub-group analysis according to age found that SCH was related to depression in younger patients (<60 years old), as defined by the diagnosis of depression: OR of 3.8 (95% CI 1.02, 14.18, P = 0.047, I = 0.0%) or an increase on the depressive scale: SMD of 0.42 (95% CI 0.03, 0.82, P = 0.036, I = 66.6%). Meanwhile, SCH did not associate with depression in older patients (≥60 years old), as defined by the diagnosis of depression: OR of 1.53 (95% CI 0.81, 2.90, P = 0.193, I = 71.3%) or an increase on the depressive scale: SMD of 0.03 (95%CI -0.31, 0.37, P = 0.857, I = 79.8%). We also found an insignificant difference in the composite endpoint between the L-T4 supplementation group and placebo group in SCH patients. The estimated SMD was 0.26 (95% CI -0.09, 0.62, P = 0.143, I = 52.9%). This meta-analysis demonstrates that SCH is not connected to depression. However, sub-group analysis according to age found that SCH is related to depression in younger patients, but not in older patients. Furthermore, we failed to find an effect of L-T4 supplementation treatment for SCH on depression.
本研究旨在评估亚临床甲状腺功能减退症（SCH）与抑郁症之间的关系。我们还分析了左甲状腺素（L-T4）对 SCH 患者抑郁的影响。我们发现复合终点无显著差异：标准均数差（SMD）为 0.23（95%置信区间（CI）-0.03，0.48，P=0.08，I=73.6%）。抑郁患者的优势比（OR）为 1.75（95%CI 0.97，3.17 P=0.064，I=64.6%）。此外，根据年龄的亚组分析发现，SCH 与年龄较小（<60 岁）的患者的抑郁有关，其定义为抑郁的诊断：OR 为 3.8（95%CI 1.02，14.18，P=0.047，I=0.0%）或抑郁量表的增加：SMD 为 0.42（95%CI 0.03，0.82，P=0.036，I=66.6%）。与此同时，SCH 与年龄较大（≥60 岁）的患者的抑郁无关，其定义为抑郁的诊断：OR 为 1.53（95%CI 0.81，2.90，P=0.193，I=71.3%）或抑郁量表的增加：SMD 为 0.03（95%CI-0.31，0.37，P=0.857，I=79.8%）。我们还发现 SCH 患者中 L-T4 补充组与安慰剂组之间的复合终点无显著差异。估计 SMD 为 0.26（95%CI-0.09，0.62，P=0.143，I=52.9%）。这项荟萃分析表明，SCH 与抑郁无关。然而，根据年龄的亚组分析发现，SCH 与年轻患者的抑郁有关，但与老年患者无关。此外，我们未能发现 L-T4 补充治疗 SCH 对抑郁的影响。
