Li Yongli, Zhao Chengyuan, Sun Shihua, Mi Guolin, Liu Changhong, Ding Guoyong, Wang Cheng, Tang Fang
Department of Gastroenterology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Provincial Lab for Clinical Immunology Translational Medicine in Universities, Jinan, Shandong, China.
Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Data Open Innovative Application Laboratory, Jinan, Shandong, China.
BMJ Ment Health. 2024 Dec 11;27(1):e301252. doi: 10.1136/bmjment-2024-301252.
Collective evidence for the bidirectional association between depression and autoimmune diseases (ADs) is scarce, especially for subgroups of patients with specific ADs. We conducted a meta-analysis to determine the incidence rates and relative risks (RRs) of depression among patients with ADs, and vice versa.
PubMed, Embase, Web of Science, Ovid, PsycNet and Cochrane were searched up to 10 September 2024. Cohort studies evaluating longitudinal risks between ADs and depression were included. Incidence rates and RRs of depression among patients with ADs and vice versa were pooled.
The analysis included 47 studies, involving over 40.77 million participants. The pooled incidence rate of depression among patients with ADs was 6.71% (95% CI 5.10% to 8.77%), with an RR of 1.85 (95% CI 1.57 to 2.19), higher in patients aged over 45 (2.30; 95% CI 1.62 to 3.26) and females (1.88; 95% CI 1.61 to 2.20). Conversely, the pooled incidence rate of ADs among depression was 0.54% (95% CI 0.24% to 1.19%), with an RR of 1.84 (95% CI 1.10 to 3.09). The incidence rate and RRs also varied across subgroups with the highest incidence rate in the musculoskeletal system and connective tissue (1.36; 95% CI 0.50 to 3.63) and RR in the genitourinary system (2.23; 95% CI 1.98 to 2.51).
This study identified a bidirectional association between depression and ADs, with higher RRs among patients aged over 45 and females. Especially higher risks were also found for specific types of ADs including endocrine, nutritional, and metabolic diseases, genitourinary system, and skin and subcutaneous tissue.
CRD42024541053.
抑郁症与自身免疫性疾病（ADs）之间双向关联的综合证据很少，尤其是针对特定自身免疫性疾病患者的亚组。我们进行了一项荟萃分析，以确定自身免疫性疾病患者中抑郁症的发病率和相对风险（RRs），反之亦然。
截至2024年9月10日，检索了PubMed、Embase、Web of Science、Ovid、PsycNet和Cochrane数据库。纳入评估自身免疫性疾病与抑郁症之间纵向风险的队列研究。汇总了自身免疫性疾病患者中抑郁症的发病率和RRs，反之亦然。
该分析纳入了47项研究，涉及超过4077万参与者。自身免疫性疾病患者中抑郁症的汇总发病率为6.71%（95%CI 5.10%至8.77%），RR为1.85（95%CI 1.57至2.19），45岁以上患者（2.30；95%CI 1.62至3.26）和女性（1.88；95%CI 1.61至2.20）的发病率更高。相反，抑郁症患者中自身免疫性疾病的汇总发病率为0.54%（95%CI 0.24%至1.19%），RR为1.84（95%CI 1.10至3.09）。发病率和RRs在不同亚组中也有所不同，肌肉骨骼系统和结缔组织的发病率最高（1.36；95%CI 0.50至3.63），生殖泌尿系统的RR最高（2.23；95%CI 1.98至2.51）。
本研究确定了抑郁症与自身免疫性疾病之间的双向关联，45岁以上患者和女性的RRs更高。在内分泌、营养和代谢疾病、生殖泌尿系统以及皮肤和皮下组织等特定类型的自身免疫性疾病中也发现了特别高的风险。
PROSPERO注册号：CRD42024541053。
