Department of Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
BMC Cardiovasc Disord. 2020 Mar 18;20(1):141. doi: 10.1186/s12872-020-01424-1.
Depression has been recognized as an independent risk factor of coronary heart disease (CHD). Moreover, there is interrelationship of both depression and CHD. However, the potential pathophysiological mechanisms remain unknown. It might be influenced by genetic and environmental factors. According to recent researches, there is potential association between serotonin transporter gene-linked polymorphic region (5-HTTLPR) polymorphism and risk of depression in CHD patients, but the results are still inconclusive. Therefore, we performed this meta-analysis based on unadjusted and adjusted data to ascertain a more precise conclusion.
We searched relevant articles through PubMed, Embase, Web of Science, Chinese BioMedical Literature (CBM) and Chinese National Knowledge Infrastructure (CNKI) databases up to August 26, 2019. Study selection and data extraction were accomplished by two authors independently. The strength of the correlation was assessed via odds ratios (ORs) with their 95% confidence intervals (95%CIs).
This meta-analysis enrolled six observational studies. Based on unadjusted data, there was significant relationship between 5-HTTLPR polymorphism and depression risk in CHD patients under all genetic models (S vs. L: OR = 1.31, 95%CI = 1.07-1.60; SS vs. LL: OR = 1.73, 95%CI = 1.12-2.67; LS vs. LL: OR = 1.47, 95%CI = 1.13-1.92; LS + SS vs. LL: OR = 1.62, 95%CI = 1.25-2.09; SS vs. LL + LS: OR = 1.33, 95%CI = 1.02-1.74). The results of adjusted data further strengthened this relationship (SS vs. LL: OR = 1.89, 95%CI = 1.28-2.80; LS vs. LL: OR = 1.69, 95%CI = 1.14-2.51; LS + SS vs. LL: OR = 1.80, 95%CI = 1.25-2.59). Subgroup analyses based on ethnicity and major depressive disorder revealed similar results to that of the overall analysis. No evidence of publication bias was observed.
Our results suggest that 5-HTTLPR polymorphism may have an important effect on the risk of depression among patients with CHD, and carriers of the S allele of 5-HTTLPR are more vulnerable to depression.
抑郁症已被认为是冠心病（CHD）的独立危险因素。此外，抑郁症和 CHD 之间存在相互关系。然而，潜在的病理生理机制尚不清楚。它可能受到遗传和环境因素的影响。根据最近的研究，5-羟色胺转运体基因连锁多态性区域（5-HTTLPR）多态性与 CHD 患者患抑郁症的风险之间存在潜在关联，但结果仍不确定。因此，我们基于未调整和调整的数据进行了这项荟萃分析，以得出更准确的结论。
我们通过 PubMed、Embase、Web of Science、中国生物医学文献数据库（CBM）和中国国家知识基础设施（CNKI）数据库检索相关文献，检索时间截至 2019 年 8 月 26 日。两名作者独立进行研究选择和数据提取。相关性强度通过比值比（OR）及其 95%置信区间（95%CI）进行评估。
这项荟萃分析纳入了六项观察性研究。基于未调整数据，在所有遗传模型下，5-HTTLPR 多态性与 CHD 患者的抑郁风险均存在显著相关性（S 与 L：OR=1.31，95%CI=1.07-1.60；SS 与 LL：OR=1.73，95%CI=1.12-2.67；LS 与 LL：OR=1.47，95%CI=1.13-1.92；LS+SS 与 LL：OR=1.62，95%CI=1.25-2.09；SS 与 LL+LS：OR=1.33，95%CI=1.02-1.74）。调整数据的结果进一步加强了这种关系（SS 与 LL：OR=1.89，95%CI=1.28-2.80；LS 与 LL：OR=1.69，95%CI=1.14-2.51；LS+SS 与 LL：OR=1.80，95%CI=1.25-2.59）。基于种族和重度抑郁症的亚组分析得出了与总体分析相似的结果。未发现发表偏倚的证据。
我们的结果表明，5-HTTLPR 多态性可能对 CHD 患者患抑郁症的风险有重要影响，携带 5-HTTLPR S 等位基因的个体更容易患抑郁症。
