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创伤后应激障碍中脂质特征的系统评价与荟萃分析

A Systematic Review and Meta-Analysis of Lipid Signatures in Post-traumatic Stress Disorder.

作者信息

Bharti Veni, Bhardwaj Aseem, Elias David A, Metcalfe Arron W S, Kim Jong Sung

机构信息

Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.

Health and Environments Research Centre (HERC) Laboratory, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.

出版信息

Front Psychiatry. 2022 May 6;13:847310. doi: 10.3389/fpsyt.2022.847310. eCollection 2022.

Abstract

BACKGROUND

Research assessing lipid levels in individuals diagnosed with post-traumatic stress disorder (PTSD) has yielded mixed results. This study aimed to employ meta-analytic techniques to characterize the relationship between the levels of lipid profiles and PTSD.

METHODS

We performed meta-analyses of studies comparing profiles and levels of lipids between PTSD patients and healthy individuals by searching Embase, Ovid Medline, Scopus, PsycINFO, and Cochrane databases for the studies until March 2021. Meta-analyses were performed using random-effects models with the restricted maximum-likelihood estimator to synthesize the effect size assessed by standardized mean difference (SMD) across studies.

FINDINGS

A total of 8,657 abstracts were identified, and 17 studies were included. Levels of total cholesterol (TC) (SMD 0.57 95% CI, 0.27-0.87, = 0.003), low-density lipoprotein (LDL) (SMD = 0.48, 95% CI, 0.19-0.76, = 0.004), and triglyceride (TG) (SMD = 0.46, 95% CI, 0.22-0.70, = 0.001) were found to be higher, while levels of high-density lipoprotein (HDL) (SMD = -0.47, -0.88 to -0.07, = 0.026) were found to be lower in PTSD patients compared to healthy controls. Subgroup analysis showed that TG levels were higher in PTSD patients who were on or off of psychotropic medications, both < 40 and ≥ 40 years of age, and having body mass index of < 30 and ≥ 30 compared to healthy controls.

INTERPRETATION

This work suggested dysregulation of lipids in PTSD that may serve as biomarker to predict the risk. The study will be useful for physicians considering lipid profiles in PTSD patients to reduce cardiovascular morbidity and mortality.

摘要

背景

评估创伤后应激障碍(PTSD)患者血脂水平的研究结果不一。本研究旨在采用荟萃分析技术来描述血脂水平与创伤后应激障碍之间的关系。

方法

我们通过检索Embase、Ovid Medline、Scopus、PsycINFO和Cochrane数据库,对截至2021年3月比较创伤后应激障碍患者与健康个体血脂谱和血脂水平的研究进行荟萃分析。使用随机效应模型和限制最大似然估计器进行荟萃分析,以综合各研究中通过标准化均数差(SMD)评估的效应大小。

结果

共识别出8657篇摘要,纳入17项研究。结果发现,创伤后应激障碍患者的总胆固醇(TC)水平(SMD = 0.57,95%CI,0.27 - 0.87,P = 0.003)、低密度脂蛋白(LDL)水平(SMD = 0.48,95%CI,0.19 - 0.76,P = 0.004)和甘油三酯(TG)水平(SMD = 0.46,95%CI,0.22 - 0.70,P = 0.001)较高,而高密度脂蛋白(HDL)水平(SMD = -0.47,-0.88至-0.07,P = 0.026)较低。亚组分析显示,与健康对照相比,正在服用或未服用精神药物、年龄<40岁和≥40岁、体重指数<30和≥30的创伤后应激障碍患者的甘油三酯水平均较高。

解读

这项研究表明创伤后应激障碍患者存在血脂失调,这可能作为预测风险的生物标志物。该研究将有助于医生考虑创伤后应激障碍患者的血脂谱,以降低心血管疾病的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1adb/9120430/9fb253b07f14/fpsyt-13-847310-g001.jpg

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