运动与抑郁症发病率的关系:前瞻性队列研究的Meta分析

Relationship between Exercise and the Incidence of Depression: A Meta-analysis of Prospective Cohort Studies

目的:运用Meta分析的方法系统评价运动与抑郁症发病率的关系,旨在为社区体育和医疗卫生工作者开展群众抑郁症预防工作提供参考。方法:从中国知网(CNKI)、PubMed和Web of Science等数据库检索在2002年1月1日至今发表的关于运动和抑郁症发病率关系的前瞻性队列研究文献,运用Review Manager5.4软件合并优势比(odd ratio, OR)并选择95%置信区间(95%CI)将纳入文献进行文献质量评价、敏感性分析、发表偏倚分析以及系统评价。结果:共检索到10324篇文献,纳入19篇文献,包括165472例受试者。通过漏斗图发现有5篇文献与其他文献之间存在较大的偏倚。Meta分析结果表明运动能够显著减少抑郁症的发病率(P<0.00001,OR=0.68,95%CI 0.63~0.74),样本量亚组分析结果均表明运动能够显著减少抑郁症的发病率(P<0.05),运动方式亚组分析结果表明一般运动(P<0.05)、休闲活动(P<0.05)和持续性运动(P<0.05)均能显著降低抑郁症的发病率但高强度运动的结果不显著(P>0.05),受试者类型亚组分析结果表明当受试者均为健康人群或受试者均为患病人群时运动能够显著减少抑郁症的发病率(P<0.05),但当受试者包含阿尔兹海默症患者时结果不显著。结论:低、中强度的运动能够显著减少抑郁症的发病率,但当进行高强度运动或患有阿尔兹海默症时无法显著降低抑郁症发病率。选择适合的运动处方可以有效预防抑郁症等心理疾病的发生。

This paper aims to systematically discuss and evaluate the relationship between performing exercise and the incidence of depression using the method of Meta-analysis, and to provide some valuable references for community sports and health care workers to carry out the prevention of depression in the communities. Methods: Prospective cohort studies on the relationship between exercise and depression incidence published from January 1 of 2002 to the present were retrieved from the databases of China Knowledge Network(CNKI), PubMed and Web of Science, and the odd ratio(OR)was combined using Review Manager 5.4 software and 95% confidence intervals(95% CI)were selected for the included literature. 95% CI were used to evaluate the quality of the included literature, sensitivity analysis, publication bias analysis, and systematic evaluation. Results: A total of 10324 papers were retrieved and 19 papers including 165472 subjects were included. Meta-analysis results showed that exercise significantly reduced the incidence of depression(P<0.00001, OR=0.68, 95% CI 0.63 ~ 0.74), sample size subgroup analysis showed that exercise significantly reduced the incidence of depression(P<0.05).The results of the subgroup analysis showed that general exercise(P<0.05), recreational activity(P<0.05)and continuous exercise(P<0.05)significantly reduced the incidence of depression, but the results of high-intensity exercise were not significant(P> 0.05), and the results of the subgroup analysis of subject type showed that exercise significantly reduced the incidence of depression when all subjects were healthy or when all subjects were sick(P<0.05), but not when the subjects included Alzheimer’s disease patients. Conclusion: Low-and moderate-intensity exercise significantly reduced the incidence of depression, but not when high-intensity exercise was performed or when Alzheimer’s disease was present. Choosing an appropriate exercise prescription can effectively prevent the occurrence of mental disorders such as depression.