Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, China.
Brain Behav. 2024 Jan;14(1):e3322. doi: 10.1002/brb3.3322.
Thyroid hormones have been indicated to be associated with depression, but their relationship with poststroke depression (PSD) remains controversial. Therefore, we performed a meta-analysis to explore the correlation between thyroid hormone levels in acute stroke and PSD.
We searched databases for eligible studies. Standard mean differences (SMD) and 95% confidence intervals (CI) were applied to evaluate the association among levels of thyroid hormones, including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), in acute stroke patients and the risk of PSD.
A total of 13 studies were included in the analysis. Compared to non-PSD patients, PSD patients had remarkably lower serum TSH and FT3 levels (TSH: SMD = -0.59, 95%CI = -1.04 to -.15, p = .009; FT3: SMD = -0.40, 95%CI = -.51 to -.30, p = .000) and higher serum FT4 levels (SMD = 0.33, 95%CI = .07-.59, p = .013). Subgroup analysis showed that there may be a more statistically significant association between FT3 and the risk of PSD compared to TSH and FT4.
Our results suggested that patients with lower serum TSH and FT3 levels as well as higher serum FT4 levels in the acute stage of stroke may be more susceptible to PSD.
甲状腺激素与抑郁症有关,但它们与脑卒中后抑郁(PSD)的关系仍存在争议。因此,我们进行了一项荟萃分析,以探讨急性脑卒中患者甲状腺激素水平与 PSD 之间的相关性。
我们检索了数据库中的相关研究。采用标准均数差(SMD)和 95%置信区间(CI)评估甲状腺激素水平(包括促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4))与急性脑卒中患者 PSD 风险之间的关系。
共有 13 项研究纳入分析。与非 PSD 患者相比,PSD 患者的血清 TSH 和 FT3 水平显著降低(TSH:SMD=-0.59,95%CI=-1.04 至-.15,p=0.009;FT3:SMD=-0.40,95%CI=-.51 至-.30,p=0.000),血清 FT4 水平升高(SMD=0.33,95%CI=0.07-.59,p=0.013)。亚组分析显示,FT3 与 PSD 风险之间的相关性可能比 TSH 和 FT4 更具统计学意义。
我们的结果表明,急性脑卒中患者血清 TSH 和 FT3 水平较低,FT4 水平较高,可能更容易发生 PSD。