Translational Psychiatry:无论甲亢还是加减,无论有无症状,均导致抑郁的风险明显增加!

2022-09-12 MedSci原创 MedSci原创

无论是临床甲亢还是亚临床甲亢均导致抑郁的风险增加

甲状腺功能亢进症和临床抑郁症很常见,甲状腺疾病和抑郁症之间的联系已经被研究了几十年。研究人员发现了甲状腺代谢、HPT-轴和情绪调节之间可能存在的几种相互作用,而甲状腺功能减退与抑郁症的关联一直是各种荟萃分析的重点。它们产生了积极的结果,但合并症的程度可能被高估了。在最新的荟萃分析中,有学者估计在基于人群的研究中发现甲状腺功能减退症会增加临床抑郁症的概率为30%。

然而,在一般人群中,这种关联的程度还没有得到荟萃分析分析。因此,来自德国的学者开展了了这个系统回顾和荟萃分析。在2020年5月之前,研究人员系统地搜索了Medline(通过PubMed)、PsycINFO和Embase数据库中关于甲亢和临床抑郁症关联的研究。在DerSimonian-Laird随机效应元分析中,计算了临床抑郁症和甲状腺功能亢进症的关联概率。

在筛选的3372篇论文中,共选择了15项研究,涉及239608名受试者,其中61%为女性,平均年龄为50岁。相对于甲状腺功能正常的人,甲亢患者被诊断为临床抑郁症的机会该67%(OR=1.67,[95% CI: 1.49; 1.87], I2: 6%; 预测区间: 1.40 to 1.99),这一结果得到了一些敏感性和亚组分析的支持。相对于明显的甲状腺功能亢进症,亚临床甲亢的风险稍低(OR=1.36 [1.06; 1.74] vs. 1.70 [1.49; 1.93])。

综上,无论是临床甲亢还是亚临床甲亢均导致抑郁的风险增加,这可能涉及神经生物学机制、共同的遗传脆弱性和慢性躯体疾病患者的临床抑郁症风险普遍升高。

 

参考文献:

Hyperthyroidism and clinical depression: a systematic review and meta-analysis. Transl Psychiatry 12, 362 (2022). https://doi.org/10.1038/s41398-022-02121-7

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    2022-09-26 bsmagic9140
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