Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain; Child and Adolescent Mental Health Unit, Jaén University Hospital, Jaén, Spain.
Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.
J Affect Disord. 2022 Oct 1;314:211-221. doi: 10.1016/j.jad.2022.07.015. Epub 2022 Jul 20.
To study differences in oxidative stress markers and antioxidants among patients with bipolar depression (BPD) and unipolar depression (UPD).
Data sources. Electronic MEDLINE/PubMed/Cochrane Library/Scopus/TripDatabase database search until 30/06/2021.
Included were articles comparing antioxidant or oxidative stress markers between adults with BPD or UPD and healthy controls (HCs).
Two authors extracted data independently. Random effects meta-analysis, calculating standardized mean differences for results from ≥3 studies.
Oxidative stress markers reported in 40 studies -1 published repeatedly- (UPD, studies = 30 n = 3072; their HCs, n = 2856; BPD, studies = 11 n = 393; their HCs, n = 540; with 1 study reporting on both UPD and BPD) included thiobarbituric acid reactive substances (TBARS), antioxidant uric acid and antioxidant-enhancing enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione-peroxidase (GPX). Compared with HCs, UPD and BPD were associated with significantly higher levels of TBARS, without differences between UPD and BPD (P = 0.11). Compared with HCs, UPD and BPD did not differ regarding the activity of the CAT (P = 0.28), SOD (P = 0.87) and GPX (P = 0.25) enzymes. However, uric acid levels were significantly higher vs HCs in BPD than in UPD among adult patients (P = 0.004). Results were heterogenous, which, for some parameters, decreased after stratification by the blood source (serum, plasma red blood cells, whole blood).
The main limitations are the small number of studies/participants in the BPD subgroup, and heterogeneity of the results.
Both BPD and UPD may be associated with an impaired oxidative stress balance, with significantly higher uric acid levels vs. HCs in UPD than in BPD.
研究双相情感障碍（BPD）和单相抑郁（UPD）患者之间氧化应激标志物和抗氧化剂的差异。
数据来源。电子 MEDLINE/PubMed/Cochrane 图书馆/Scopus/TripDatabase 数据库检索截至 2021 年 6 月 30 日。
纳入了比较 BPD 或 UPD 成年患者与健康对照者（HCs）之间抗氧化剂或氧化应激标志物的文章。
两名作者独立提取数据。对于结果来自≥3 项研究的情况，采用随机效应荟萃分析，计算标准化均数差。
共纳入 40 项研究（其中 1 项重复发表）的氧化应激标志物数据（UPD 研究=30 项，n=3072；其 HCs，n=2856；BPD 研究=11 项，n=393；其 HCs，n=540；有 1 项研究同时报告了 UPD 和 BPD），包括硫代巴比妥酸反应物质（TBARS）、抗氧化尿酸和抗氧化增强酶超氧化物歧化酶（SOD）、过氧化氢酶（CAT）和谷胱甘肽过氧化物酶（GPX）。与 HCs 相比，UPD 和 BPD 与 TBARS 水平显著升高相关，而 UPD 和 BPD 之间无差异（P=0.11）。与 HCs 相比，UPD 和 BPD 之间 CAT（P=0.28）、SOD（P=0.87）和 GPX（P=0.25）酶的活性无差异。然而，与 HCs 相比，BPD 成年患者尿酸水平显著升高（P=0.004）。结果存在异质性，对于某些参数，在按血液来源（血清、血浆红细胞、全血）分层后，异质性降低。
主要的局限性是 BPD 亚组的研究/参与者数量较少，以及结果的异质性。
BPD 和 UPD 两者可能都与氧化应激平衡受损有关，与 HCs 相比，UPD 中尿酸水平显著升高，而 BPD 中尿酸水平较低。
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