Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany.
Faculty of Medicine, Cairo University, Cairo, Egypt.
Trends Psychiatry Psychother. 2023;45:e20230338. doi: 10.47626/2237-6089-2021-0338. Epub 2021 Nov 19.
Major depressive disorder (MDD) is a severe mental health condition that affects millions of people worldwide. Etiologically, several factors may play a role in its development. Previous studies have reported elevated plasminogen activator inhibitor-1 (PAI-1) levels in patients with depression, suggesting that PAI-1 levels might be linked to the etiology of MDD.
We systematically searched the following online databases: MEDLINE, Scopus, and Web of Science up to September 10, 2020, to identify studies in which PAI-1 levels were reported in subjects with MDD. Subsequently we used RevMan 5.3 to perform a meta-analysis of data extracted from the included studies using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PICO criteria for the search and analysis.
Six studies that reported mean ± standard deviation (SD) were included in the analysis, with a total of 507 MDD patients and 3,453 controls. The overall standardized mean difference (SMD) was 0.27 (95% confidence interval [95% CI] 0.01-0.53). PAI-1 serum levels were 0.27 SDs higher in MDD patients than in controls. The test for overall effect was significant (z = 2.04, p = 0.04). Substantial heterogeneity was detected among the studies, demonstrated by the inconsistency test (I² = 72%) and the chi-square test (χ² = 18.32; p = 0.003).
This systematic review and meta-analysis showed that MDD might be related to elevated PAI-1 levels. We propose larger prospective clinical studies to further investigate this clinical correlation and validate the clinical significance of these observations.
重度抑郁症（MDD）是一种严重的精神健康状况，影响着全球数百万人。从病因学上讲，有几个因素可能在其发展中起作用。先前的研究报告称，抑郁症患者的纤溶酶原激活物抑制剂-1（PAI-1）水平升高，这表明 PAI-1 水平可能与 MDD 的病因有关。
我们系统地检索了以下在线数据库：MEDLINE、Scopus 和 Web of Science，截至 2020 年 9 月 10 日，以确定报告 MDD 患者 PAI-1 水平的研究。随后，我们使用 RevMan 5.3 根据 PRISMA 和 PICO 标准对纳入的研究进行数据提取和荟萃分析。
纳入的分析共包括 6 项研究，报告了均数±标准差（SD），共纳入 507 例 MDD 患者和 3453 例对照。总标准化均数差（SMD）为 0.27（95%置信区间 [95%CI] 0.01-0.53）。与对照组相比，MDD 患者的 PAI-1 血清水平高 0.27 SD。总效应检验具有统计学意义（z = 2.04，p = 0.04）。研究之间存在显著的异质性，表现在不一致性检验（I² = 72%）和卡方检验（χ² = 18.32；p = 0.003）。
本系统评价和荟萃分析表明，MDD 可能与 PAI-1 水平升高有关。我们建议进行更大规模的前瞻性临床研究，以进一步探讨这种临床相关性，并验证这些观察结果的临床意义。
