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糖尿病中的脑源性神经营养因子：系统评价和荟萃分析。

Brain-derived neurotrophic factor in diabetes mellitus: A systematic review and meta-analysis.

机构信息

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

出版信息

PLoS One. 2023 Feb 14;18(2):e0268816. doi: 10.1371/journal.pone.0268816. eCollection 2023.

DOI:10.1371/journal.pone.0268816
PMID:36787304
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9928073/
Abstract

BACKGROUND

Brain-derived neurotrophic factor (BDNF) is a neurotrophic factor expressed in several tissues, including the brain, gut, and pancreas. Activation of the BDNF/TrkB/CREB reduces hepatic gluconeogenesis, induces hepatic insulin signal transduction, and protects against pancreatic beta-cell loss in diabetes mellitus (DM). Several studies have investigated the possible association between BDNF and DM and its complications, but the results have been conflicting.

AIM

In the present study, we aimed at systematically reviewing the literature on the serum and plasma levels of BDNF in DM and its subgroups such as T2DM, DM patients with depression, and patients with retinopathy.

METHODS

A comprehensive search was conducted in PubMed, Scopus, and Web of Science. We identified 28 eligible studies and calculated the standardized mean difference (SMD) of outcomes as an effect measure.

RESULTS

The meta-analysis included 2734 patients with DM and 6004 controls. Serum BDNF levels were significantly lower in patients with DM vs. controls (SMD = -1.00, P<0.001). Plasma BDNF levels were not different in patients with DM compared with controls. When conducting subgroup analysis, serum BDNF levels were lower among patients with T2DM (SMD = -1.26, P<0.001), DM and depression (SMD = -1.69, P<0.001), and patients with diabetic retinopathy (DR) vs. controls (SMD = -1.03, P = 0.01).

CONCLUSIONS

Serum BDNF levels were lower in patients with DM, T2DM, DM with depression, and DM and DR than the controls. Our findings are in line with the hypothesis that decreased BDNF levels might impair glucose metabolism and contribute to the pathogenesis of DM and its complications.

摘要

背景

脑源性神经营养因子（BDNF）是一种在多种组织中表达的神经营养因子，包括大脑、肠道和胰腺。BDNF/TrkB/CREB 的激活可减少肝糖异生，诱导肝胰岛素信号转导，并预防糖尿病（DM）中的胰岛β细胞丢失。多项研究调查了 BDNF 与 DM 及其并发症之间的可能关联，但结果存在矛盾。

目的

本研究旨在系统综述有关 DM 及其亚组（如 2 型糖尿病、合并抑郁的 DM 患者和伴有视网膜病变的患者）患者血清和血浆 BDNF 水平的文献。

方法

我们在 PubMed、Scopus 和 Web of Science 中进行了全面检索。我们确定了 28 项符合条件的研究，并计算了结局的标准化均数差值（SMD）作为效应量。

结果

荟萃分析纳入了 2734 名 DM 患者和 6004 名对照者。与对照者相比，DM 患者的血清 BDNF 水平显著降低（SMD=-1.00，P<0.001）。DM 患者的血浆 BDNF 水平与对照者无差异。进行亚组分析时，与对照者相比，2 型糖尿病患者（SMD=-1.26，P<0.001）、合并抑郁的 DM 患者（SMD=-1.69，P<0.001）和伴有糖尿病视网膜病变的 DM 患者（SMD=-1.03，P=0.01）的血清 BDNF 水平更低。

结论

与对照者相比，DM、2 型糖尿病、合并抑郁的 DM 和伴有糖尿病视网膜病变的 DM 患者的血清 BDNF 水平更低。我们的发现与 BDNF 水平降低可能损害葡萄糖代谢并有助于 DM 及其并发症发病机制的假说一致。

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