先前的研究表明,神经肽Y(NPY)水平可能会在患有重度抑郁症(MDD)的患者中发生改变。创伤后应激障碍(PTSD)和慢性应激。我们调查了,通过系统回顾和荟萃分析,MDD患者的NPY平均水平是否有显著差异,创伤后应激障碍或慢性压力,与对照组相比。主要结果是病例和对照之间的合并标准化平均差(SMD)和95%置信区间,使用随机效应模型。评估异质性和发表偏倚。35项研究符合资格标准。荟萃回归确定药物和性别可以解释研究之间差异的27%。目前服用精神药物的女性和参与者的NPY水平明显较高。与对照组相比,PTSD患者血浆和脑脊液(CSF)中的NPY水平显着降低。与对照组相比,MDD患者血浆中NPY水平显著降低,但在脑脊液中没有.PTSD和MDD之间血浆NPY水平降低的幅度没有显着差异。然而,慢性应激患者的血浆NPY水平明显高于对照组,PTSD或MDD。我们的发现可能暗示NPY在创伤和抑郁中的共同作用:尽管如此,尚不清楚这种关联是否特定于这些疾病。精神药物可能有助于恢复NPY水平。需要进一步的对照研究来更好地描述混杂变量的贡献,例如抑郁症的类型,身体质量指数,食欲或睡眠结构。
Previous studies have suggested that neuropeptide Y (NPY) levels may be altered in patients with major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and chronic stress. We investigated, through systematic
review and meta-analysis, whether the mean levels of NPY are significantly different in patients with MDD, PTSD or chronic stress, compared to controls. The main outcome was the pooled standardized mean difference (SMD) with 95% confidence intervals between cases and controls, using the random-effects model. Heterogeneity and publication bias were evaluated. Thirty-five studies met eligibility criteria. Meta-regression determined that medication and sex could explain 27% of the between-study variance. Females and participants currently prescribed psychotropic medications had significantly higher levels of NPY. NPY levels were significantly lower in plasma and cerebrospinal fluid (CSF) in PTSD patients versus controls. Patients with MDD had significantly lower levels of NPY in plasma compared to controls, but not in the CSF. The magnitudes of the decrease in plasma NPY levels were not significantly different between PTSD and MDD. However, chronic stress patients had significantly higher plasma NPY levels compared to controls, PTSD or MDD. Our findings may imply a shared role of NPY in trauma and depression: nevertheless, it is not clear that the association is specific to these disorders. Psychotropic medications may help restore NPY levels. Further controlled studies are needed to better delineate the contribution of confounding variables such as type of depression, body mass index, appetite or sleep architecture.