Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France.
NARSM (Núcleo de Revisão Sistemática e Meta-análise), Curitiba, Brazil.
J Oral Rehabil. 2023 Nov;50(11):1279-1315. doi: 10.1111/joor.13536. Epub 2023 Jul 4.
Some studies have shown burning mouth syndrome (BMS) as comorbid psychosocial and psychiatric disorders, and as well, pointed at stress as a major risk factor.
The aim of this meta-analysis was to answer the following question: 'Is there an association between BMS and stress, compared to healthy controls?'
Two reviewers searched for the effect of stress in BMS and published on five main databases and three from the grey literature. Various questionnaires and biomarkers were analysed. Of the 2489 selected articles, 30 met the inclusion criteria. Studies englobed questionnaires, such as Perceived Stress Questionnaire, Lipp Stress Symptoms Inventory, Holmes-Rahe scale, Depression, Anxiety, and Stress Scale (DASS-21), Recent Experience Test; and various biomarkers, such as cortisol, opiorphin, IgA, α-amylase and interleukins.
In all studies with questionnaires, stress was significantly increased in the BMS group vs. control. Patients with BMS presented 25.73% higher cortisol levels, 28.17% higher IgA levels and 40.62% higher α-amylase levels than controls. Meta-analysis found that BMS subjects presented 3.01 nmoL/L [0.53; 5.50] higher cortisol levels, 84.35 kU/L [15.00; 153.71] higher α-amylase levels, 29.25 mg/mL [9.86; 48.64] higher IgA levels and 258.59 pg/mL [59.24; 457.94] higher IL-8 levels than control. No differences were found for opiorphin concentration in ng/mL [-0.96; 2.53]. For interleukins, no differences were founded for IL-1 β, IL-2, IL-4, IL-6, IL-8, IL-10 and TNF-α.
Based on the available evidence, this meta-analysis suggests more stress factors in questionnaire-based studies, and higher levels of cortisol, α-amylase, IgA and IL-8 biomarkers in BMS subjects than controls.
一些研究表明，灼口综合征（BMS）与心理社会和精神障碍并存，并且压力是一个主要的危险因素。
本荟萃分析旨在回答以下问题：“与健康对照组相比，BMS 与压力之间是否存在关联？”
两位审查员搜索了 BMS 中压力的影响，并在五个主要数据库和三个灰色文献中进行了搜索。分析了各种问卷和生物标志物。在 2489 篇选定的文章中，有 30 篇符合纳入标准。这些研究包括问卷，如感知压力问卷、Lipp 压力症状量表、Holmes-Rahe 量表、抑郁、焦虑和压力量表（DASS-21）、近期经历测试；以及各种生物标志物，如皮质醇、阿片肽、IgA、α-淀粉酶和白细胞介素。
在所有使用问卷的研究中，BMS 组的压力明显高于对照组。BMS 患者的皮质醇水平升高 25.73%，IgA 水平升高 28.17%，α-淀粉酶水平升高 40.62%。荟萃分析发现，BMS 患者的皮质醇水平升高 3.01 nmol/L [0.53；5.50]，α-淀粉酶水平升高 84.35 kU/L [15.00；153.71]，IgA 水平升高 29.25 mg/mL [9.86；48.64]，IL-8 水平升高 258.59 pg/mL [59.24；457.94]，而阿片肽浓度在 ng/mL 中没有差异[-0.96；2.53]。对于白细胞介素，IL-1β、IL-2、IL-4、IL-6、IL-8、IL-10 和 TNF-α 均未发现差异。
根据现有证据，本荟萃分析表明，基于问卷的研究中存在更多的压力因素，BMS 患者的皮质醇、α-淀粉酶、IgA 和 IL-8 生物标志物水平高于对照组。
