Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Psychol Med. 2023 Apr;53(5):2017-2030. doi: 10.1017/S0033291721003767. Epub 2021 Nov 9.
Accumulating evidence suggests that alterations in inflammatory biomarkers are important in depression. However, previous meta-analyses disagree on these associations, and errors in data extraction may account for these discrepancies.
PubMed/MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from database inception to 14 January 2020. Meta-analyses of observational studies examining the association between depression and levels of tumor necrosis factor- (TNF-), interleukin 1- (IL-1), interleukin-6 (IL-6), and C-reactive protein (CRP) were eligible. Errors were classified as follows: incorrect sample sizes, incorrectly used standard deviation, incorrect participant inclusion, calculation error, or analysis with insufficient data. We determined their impact on the results after correction thereof.
Errors were noted in 14 of the 15 meta-analyses included. Across 521 primary studies, 118 (22.6%) showed the following errors: incorrect sample sizes (20 studies, 16.9%), incorrect use of standard deviation (35 studies, 29.7%), incorrect participant inclusion (7 studies, 5.9%), calculation errors (33 studies, 28.0%), and analysis with insufficient data (23 studies, 19.5%). After correcting these errors, 11 (29.7%) out of 37 pooled effect sizes changed by a magnitude of more than 0.1, ranging from 0.11 to 1.15. The updated meta-analyses showed that elevated levels of TNF- , IL-6, CRP, but not IL-1, are associated with depression.
These findings show that data extraction errors in meta-analyses can impact findings. Efforts to reduce such errors are important in studies of the association between depression and peripheral inflammatory biomarkers, for which high heterogeneity and conflicting results have been continuously reported.
越来越多的证据表明，炎症生物标志物的改变在抑郁症中很重要。然而，之前的荟萃分析对这些关联存在分歧，数据提取中的错误可能是造成这些差异的原因。
从数据库建立到 2020 年 1 月 14 日，我们检索了 PubMed/MEDLINE、Embase、PsycINFO 和 Cochrane Library。符合条件的是观察性研究荟萃分析，这些研究检查了抑郁与肿瘤坏死因子-（TNF-）、白细胞介素 1-（IL-1）、白细胞介素 6（IL-6）和 C 反应蛋白（CRP）水平之间的关联。错误分为以下几类：不正确的样本量、不正确使用标准差、不正确的参与者纳入、计算错误或分析数据不足。我们在纠正这些错误后确定了它们对结果的影响。
在纳入的 15 项荟萃分析中，有 14 项存在错误。在 521 项主要研究中，有 118 项（22.6%）存在以下错误：不正确的样本量（20 项研究，16.9%）、不正确使用标准差（35 项研究，29.7%）、不正确的参与者纳入（7 项研究，5.9%）、计算错误（33 项研究，28.0%）和分析数据不足（23 项研究，19.5%）。在纠正这些错误后，37 个汇总效应大小中有 11 个（29.7%）变化幅度超过 0.1，范围从 0.11 到 1.15。更新的荟萃分析表明，TNF-、IL-6 和 CRP 水平升高与抑郁有关，但 IL-1 水平升高与抑郁无关。
这些发现表明，荟萃分析中的数据提取错误会影响研究结果。在抑郁症与外周炎症生物标志物相关性的研究中，努力减少此类错误很重要，因为这些研究一直报告存在高度异质性和相互矛盾的结果。
