Gatta Elisa, Dondi Francesco, Pirola Ilenia, Delbarba Andrea, Maltese Virginia, Bellini Pietro, Ugoccioni Massimiliano, Silvestrini Irene, Rotondi Mario, Bertagna Francesco, Cappelli Carlo
Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili, 25121 Brescia, Italy.
Centro per la Diagnosi e Cura delle Neoplasie Endocrine e delle Malattie della Tiroide, University of Brescia, 25121 Brescia, Italy.
J Clin Med. 2025 Aug 23;14(17):5959. doi: 10.3390/jcm14175959.
: Thyroid dysfunction and psychiatric disorders often coexist, raising interest in their potential interplay. In particular, the relationship between thyroid-stimulating hormone (TSH) levels and schizophrenia has been investigated, though findings remain inconsistent. We performed a systematic review and meta-analysis to clarify whether TSH levels differ in patients with schizophrenia compared with healthy controls. : A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted up to May 2025. Eligible studies were selected based on predefined criteria according to the PICO framework: What are the TSH levels in first-episode, drug-naïve patients diagnosed with schizophrenia compared with healthy subjects, and do TSH levels influence different psychiatric phenotypes? PRISMA guidelines were followed. Study quality and risk of bias were assessed using QUADAS-2. : Of 2068 records screened, 35 studies met the inclusion criteria. Quality assessment revealed a generally unclear risk of bias, with few studies showing a high risk. The meta-analysis included 3669 patients and 1391 controls from ten Asian, eight European, and three North American studies. TSH levels were similar between patients and controls (SMD = -0.059 mIU/L; 95% CI: -0.260 to 0.141), with substantial heterogeneity (I = 84%, < 0.001). : This meta-analysis found no significant association between TSH levels and schizophrenia, despite decades of research and methodological diversity.
甲状腺功能障碍与精神疾病常常并存，这引发了人们对它们潜在相互作用的兴趣。特别是，甲状腺刺激激素（TSH）水平与精神分裂症之间的关系已得到研究，尽管结果仍不一致。我们进行了一项系统综述和荟萃分析，以阐明精神分裂症患者与健康对照者的TSH水平是否存在差异。
截至2025年5月，我们对PubMed/MEDLINE、Scopus和Web of Science进行了系统检索。根据PICO框架的预定义标准选择符合条件的研究：与健康受试者相比，首次发作、未使用过药物的精神分裂症患者的TSH水平如何，以及TSH水平是否影响不同的精神表型？遵循PRISMA指南。使用QUADAS-2评估研究质量和偏倚风险。
在筛选的2068条记录中，35项研究符合纳入标准。质量评估显示，总体偏倚风险尚不清楚，只有少数研究显示高风险。荟萃分析纳入了来自亚洲10项、欧洲8项和北美3项研究的3669例患者和1391例对照。患者和对照之间的TSH水平相似（标准化均数差= -0.059 mIU/L；95%置信区间：-0.260至0.141），存在显著异质性（I² = 84%，P < 0.001）。
尽管经过数十年的研究和方法多样性，这项荟萃分析发现TSH水平与精神分裂症之间没有显著关联。
