Huang Yue-Ping, Xue Ju-Jun, Li Chao, Chen Xi, Fu Hong-Juan, Fei Teng, Bi Peng-Xiang
Department of Gerontological Neurology, Heilongjiang Provincial Hospital, Harbin, China.
Department of Neurology, Hongqi Hospital, Mudanjiang Medical College, Mudanjiang, China.
Psychiatry Investig. 2020 Sep;17(9):858-864. doi: 10.30773/pi.2019.0324. Epub 2020 Aug 28.
To evaluate the associative role of depression and apolipoprotein E epsilon 4 allele (APOEε4) in subjective cognitive decline (SCD) and its progression to objective cognitive decline.
After literature search in electronic databases, studies were selected by following precise eligibility criteria. Meta-analyses were performed to examine the role of APOEε4 and depression in SCD or its progression to mild cognitive impairment (MCI) or dementia.
APOEε4 positivity was not different between SCD and normal individuals but was significantly higher in individuals with SCD plus than in normal individuals [odds ratio: 2.39 (95% CI: 1.87, 3.05); p<0.00001] and in SCD converters than in non-converters [odds ratio: 5.19 (95% CI: 2.36, 11.42); p<0.00001]. Depression was significantly higher in individuals with SCD [standardized mean difference: 0.63 (0.45, 0.82); p<0.00001] and SCD plus [standardized mean difference: 0.83 (0.43, 1.22); p<0.0001] than in normal individuals. However, depression was not different between SCD and MCI or between SCD converters and non-converters. Age of SCD converters was higher than non-converters [mean difference: 2.95 years (0.58, 5.31)].
Whereas APOEε4 positivity was higher in SCD plus and SCD converters, depression was higher in SCD and SCD plus but was not different between SCD and MCI.
评估抑郁症与载脂蛋白Eε4等位基因（APOEε4）在主观认知下降（SCD）及其向客观认知下降进展过程中的关联作用。
在电子数据库中进行文献检索后，按照精确的纳入标准选择研究。进行荟萃分析以检验APOEε4和抑郁症在SCD或其向轻度认知障碍（MCI）或痴呆进展中的作用。
SCD患者与正常个体之间的APOEε4阳性率无差异，但SCD伴发其他情况者的APOEε4阳性率显著高于正常个体[优势比：2.39（95%置信区间：1.87，3.05）；p<0.00001]，SCD进展者的APOEε4阳性率高于未进展者[优势比：5.19（95%置信区间：2.36，11.42）；p<0.00001]。SCD患者[标准化均数差：0.63（0.45，0.82）；p<0.00001]和SCD伴发其他情况者[标准化均数差：0.83（0.43，1.22）；p<0.0001]的抑郁症发生率显著高于正常个体。然而，SCD患者与MCI患者之间以及SCD进展者与未进展者之间的抑郁症发生率无差异。SCD进展者的年龄高于未进展者[平均差：2.95岁（0.58，5.31）]。
虽然SCD伴发其他情况者和SCD进展者的APOEε4阳性率较高，但SCD患者和SCD伴发其他情况者的抑郁症发生率较高，而SCD患者与MCI患者之间的抑郁症发生率无差异。
