Chen Xinda, Zhao Peiyi, Wang Weihao, Guo Lixin, Pan Qi
Department of Endocrinology (XC), Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Beijing, China.
Department of Endocrinology (PZ, WW, LG, QP), Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Graduate School of Peking Union Medical College (PZ), Beijing 100730, China.
Am J Geriatr Psychiatry. 2024 Jan;32(1):117-127. doi: 10.1016/j.jagp.2023.08.010. Epub 2023 Aug 21.
AIM/HYPOTHESIS: Emerging evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may exert positive effects in patients with depression. Our aim was to conduct a systematic review and meta-analysis to examine the antidepressant effects of GLP-1RAs.
Randomized controlled trials and prospective cohort studies investigating the effects of GLP-1RAs versus placebo or other antidiabetic therapies on depressive symptoms were searched for using multiple electronic sources (CENTRAL, PubMed, EMBASE, PsycINFO, World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, China Network Knowledge Infrastructure, China Biomedical Database, Wan Fang data, and Chinese Scientific Journals Database) from inception to February 16, 2023. We utilized a random effects model to analyze standardized mean differences for the change in depression rating scales comparing GLP-1RA treated groups with control treated groups.
The meta-analysis comprising 2,071 participants included 5 randomized controlled trials and 1 prospective cohort study. The meta-analysis indicated that the change from baseline in depression rating scale scores decreased significantly when patients received treatment with GLP-1RAs compared to control treatments (SMD = -0.12, 95% CI [-0.21, -0.03], p <0.01, I = 0%, p = 0.52). The subgroup analysis showed that the effects of GLP-1RAs on depressive symptoms were consistent in patients with Type 2 diabetes mellitus (SMD = -0.12, 95% CI [-0.21, -0.03], p <0.01, I = 2%, p = 0.40).
Adults treated with GLP-1RAs showed significant reductions in the depression rating scale scores compared to those treated with control substances. Our findings suggest that GLP-1RAs may be a potential treatment for alleviating depressive symptoms in humans.
目的/假设：新出现的证据表明，胰高血糖素样肽-1受体激动剂（GLP-1RAs）可能对抑郁症患者产生积极影响。我们的目的是进行一项系统评价和荟萃分析，以研究GLP-1RAs的抗抑郁作用。
使用多个电子资源库（Cochrane系统评价数据库、PubMed、EMBASE、PsycINFO、世界卫生组织国际临床试验注册平台、ClinicalTrials.gov、中国知网、中国生物医学数据库、万方数据和中文科技期刊数据库）检索从建库至2023年2月16日期间，调查GLP-1RAs与安慰剂或其他抗糖尿病疗法相比对抑郁症状影响的随机对照试验和前瞻性队列研究。我们使用随机效应模型分析比较GLP-1RA治疗组与对照治疗组抑郁评定量表变化的标准化平均差异。
该荟萃分析纳入了2071名参与者，包括5项随机对照试验和1项前瞻性队列研究。荟萃分析表明，与对照治疗相比，患者接受GLP-1RAs治疗时，抑郁评定量表分数较基线的变化显著降低（标准化平均差= -0.12，95%置信区间[-0.21, -0.03]，p<0.01，I² = 0%，p = 0.52）。亚组分析显示，GLP-1RAs对2型糖尿病患者抑郁症状的影响是一致的（标准化平均差= -0.12，95%置信区间[-0.21, -0.03]，p<0.01，I² = 2%，p = 0.40）。
与接受对照药物治疗的成年人相比，接受GLP-1RAs治疗的成年人抑郁评定量表分数显著降低。我们的研究结果表明，GLP-1RAs可能是缓解人类抑郁症状的一种潜在治疗方法。
