血清BDNF水平及BDNF Val66Met基因多态性与冠心病患者合并抑郁症状关系的Meta分析

Correlation of serum BDNF level and BDNF Val66Met gene polymorphism with depression in patients with coronary heart disease:a Meta-analysis

目的探讨血清脑源性神经营养因子(BDNF)水平及BDNF Val66Met基因多态性与冠心病患者合并抑郁症状的关系。方法计算机检索中国生物医学文献数据库、中国知网、万方数据库和维普中文科技期刊全文数据库、PubMed、Medline、Web of Science、Cochrane Library、EMbase。各数据库的检索时间均为建库至2020年11月10日。收集所有检测血清BDNF水平和(或)BDNF Val66Met基因多态性并对冠心病患者抑郁症状进行评定的病例对照或队列研究,采用RevMan 5.3软件对数据进行统计分析。结果共纳入10篇文献,涉及受试者2093例。Meta分析结果显示,与冠心病不合并抑郁症状患者相比,冠心病合并抑郁症状患者血清BDNF水平降低(MD=-2.09,95%CI:-3.84~-0.34,P<0.05),经皮冠状动脉介入(PCI)术后血清BDNF水平降低(MD=-7.86,95%CI:-8.45~-7.28,P<0.01),而PCI术后汉密尔顿抑郁量表(HAMD)评分升高(MD=23.04,95%CI:21.82~24.27,P<0.01)。与冠心病不合并抑郁症状患者相比,冠心病合并抑郁症状患者出现VV基因型频率降低(OR=0.23,95%CI:0.06~0.96,P<0.05),但VM、MM基因型差异均无统计学意义(均P>0.05)。结论血清BDNF可能是预测冠心病患者是否合并抑郁的生物标志物,并且与冠心病患者PCI术后发生抑郁密切相关,但本次研究不能证明BDNF Val66Met基因多态性与冠心病合并抑郁症状有关。

Objective To investigate the correlation of serum brain-derived neurotrophic factor(BDNF)level and BDNF Val66Met gene polymorphism with depression in patients with coronary heart disease(CHD).Methods The databeses of CBM,CNKI,Wanfang,VIP Chinese Science,PubMed,Medline,Web of Science,Cochrane Library and EMbase from the inception to November 10,2020 were searched for studies regarding the correlation of serum BDNF level and BDNF Val66Met gene polymorphism with depression in patients with CHD.RevMan 5.3 software was used in Meta-analysis.Results Ten articles involving 2093 patients were included in the analysis.Meta-analysis results showed that the serum BDNF level of patients with CHD in the depression group was significantly lower than that of patients without depression(MD=-2.09,95%CI:-3.84~-0.34,P<0.05).Compared with patients without depression,the serum BDNF level of patients with depression group after PCI was reduced(MD=-7.86,95%CI:-8.45~-7.28,P<0.01)and the HAMD score increased significantly after PCI(MD=23.04,95%CI:21.82~24.27,P<0.01).The frequency of VV genotypes in CHD patients with depression was significantly lower than that in the patients without depression(OR=0.23,95%CI:0.06~0.96,P<0.05).However,there was no statistically significance in frequency of VM and MM genotypes between CHD patients with depression and without depression(all P>0.05).Conclusion Serum BDNF is significantly associated with the development of depression in CHD patients,and also closely related with depression in CHD patients after PCI,but this study could not prove that the BDNF Val66Met gene polymorphism is associated with CHD patients with depression.