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褪黑素补充对 BDNF 浓度和抑郁的影响:随机对照试验的系统评价和荟萃分析。

Effects of melatonin supplementation on BDNF concentrations and depression: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Nutrition and Food Security Research Center, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.

Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Behav Brain Res. 2023 Jan 5;436:114083. doi: 10.1016/j.bbr.2022.114083. Epub 2022 Aug 29.

Abstract

PURPOSE

The aim of this comprehensive systematic review and meta-analysis was to evaluate the beneficial effects of melatonin supplementation on brain-derived neurotrophic factor (BDNF) concentration and clinical depressive disorder.

METHODS

A comprehensive electronic search was conducted of Medlin, Web of Science, Science Direct, and Google scholar, from database inception to January 20, 2021. Studies were eligible if they: (1) were a clinical trial; (2) enrolled adults; (3) assessed the effect of melatonin supplementation on serum concentration of BDNF or depression score. Overall effects, as weighted mean difference (WMD), were calculated for concentration of BDNF and depression score.

RESULTS

Melatonin supplementation yielded no significant effect on BDNF concentration (WMD: -5.61; 95% CI: -14.10, 2.88; I-square: 85.6%), but improved depression by decreasing the score (WMD: -0.76; 95% CI: -1.12, -0.4; I-square: 88.0%). Due to high heterogeneity between studies, subgroup analysis for gender, duration and dose in BDNF studies and duration, age, dose, continent and Questionnaire type in depression studies, was utilised. The subgroup analysis showed that melatonin supplementation had a significant decreasing effect on BDNF levels in doses ≤ 10 mg/day, with more than 4 weeks of duration, and in men.

CONCLUSION

The present study revealed that melatonin supplementation has a decreasing effect on depression in all duration of studies and doses subgroup and in age more than 65 years in depression studies but heterogenicity of the included studies, did not allow a definitive conclusion. There is limited evidence for effects of melatonin on serum BDNF.

IMPLICATIONS FOR PRACTICE

Melatonin is a safe and effective supplement for depressive patients.

摘要

目的

本全面系统评价和荟萃分析旨在评估褪黑素补充对脑源性神经营养因子 (BDNF) 浓度和临床抑郁障碍的有益影响。

方法

对 Medlin、Web of Science、Science Direct 和 Google Scholar 进行了全面的电子检索,检索时间从数据库建立到 2021 年 1 月 20 日。如果研究符合以下标准,则为合格研究:(1)为临床试验;(2)纳入成年人;(3)评估褪黑素补充对血清 BDNF 浓度或抑郁评分的影响。总体效应以加权均数差 (WMD) 表示,用于计算 BDNF 浓度和抑郁评分。

结果

褪黑素补充对 BDNF 浓度没有显著影响(WMD:-5.61;95%CI:-14.10,2.88;I 平方:85.6%),但通过降低评分改善了抑郁(WMD:-0.76;95%CI:-1.12,-0.4;I 平方:88.0%)。由于研究之间存在高度异质性,因此对 BDNF 研究中的性别、持续时间和剂量亚组以及抑郁研究中的持续时间、年龄、剂量、大陆和问卷类型进行了亚组分析。亚组分析表明,褪黑素补充在剂量≤10mg/天、持续时间超过 4 周以及男性中对 BDNF 水平有显著降低作用。

结论

本研究表明,褪黑素补充在所有研究持续时间和剂量亚组以及年龄大于 65 岁的抑郁研究中对抑郁有降低作用,但纳入研究的异质性不允许得出明确的结论。褪黑素对血清 BDNF 影响的证据有限。

实践意义

褪黑素是治疗抑郁患者的一种安全有效的补充剂。

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