唾液皮质醇水平与抑郁情绪相关性的Meta分析

Meta-Analysis of the Correlation between Salivary Cortisol Level and Depressive Mood

摘要: 目的：通过Meta分析方法评价唾液皮质醇水平与抑郁情绪的相关性，为早期发现抑郁情绪；诊断抑郁症提供证据。方法：计算机检索web of Science、the Cochrane Library、PubMed、CNKI、VIP、WangFang Database、CBM数据库，收集唾液皮质醇水平与抑郁情绪相关性的队列研究，检索时间均从建库至2022年11月1日，由2名研究员独立筛选文献、提取资料并利用NOS量表评估纳入原始研究的偏倚风险后，采用Review Manager 5.4.1软件进行Meta分析。结果：共纳入12个队列研究，包括1614名研究对象。Meta分析结果显示无论是清晨唾液皮质醇水平还是夜间唾液皮质醇水平，抑郁组与非抑郁组的唾液皮质醇浓度的差异均有统计学意义[MD清晨 = 4.44, 95% CI (2.39, 6.49), P < 0.001; SMD夜间 = 0.93, 95% CI (0.24, 1.62), P = 0.008]。且分别以测定方法(酶联免疫吸附法，电化学发光法)和量表(HAMD, EPDS)为类别进行了亚组分析[MD酶联免疫 = 3.25, 95% CI (1.56, 4.93), P = 0.002; MD电化学发光 = 0.53, 95% CI (0.11, 0.96)，P = 0.01; MDHAMD = 8.91, 95% CI (5.43, 12.38), P < 0.001; MDEPDS = 0.64, 95% CI (0.22, 1.05), P = 0.003]。结论：现有证据表明，唾液皮质醇水平与抑郁情绪存在一定的相关性，清晨唾液皮质醇水平高于其他时间段，且受不同的测量方式影响其水平的高低。此外，抑郁程度与唾液皮质醇水平还有一定程度地正相关。

Abstract: Objective: To evaluate the correlation between salivary cortisol level and depressive mood through meta-analysis, and provide evidence for early detection and diagnosis of depression. Methods: Relevant studies were retrieved from Web of Science, the Cochrane Library, PubMed, CNKI, VIP, WangFang Database, and CBM Database, from inception until November 1, 2022. Two independent reviewers screened the literature, extracted data, and evaluated the bias risk of the included studies using the NOS scale. Meta-analysis was performed using Review Manager 5.4.1 software. Results: A total of 12 cohort studies involving 1614 subjects were included in this meta-analysis. The results showed that there was a significant difference in salivary cortisol concentration between the depressed group and the non-depressed group, both in the morning and at night [MD morning = 4.44, 95% CI (2.39, 6.49), P < 0.001; SMD night = 0.93, 95% CI (0.24, 1.62), P = 0.008]. Subgroup analysis was performed based on the detec-tion method (enzyme-linked immunosorbent assay, electrochemiluminescence) and scale (HAMD, EPDS) [MD ELISA = 3.25, 95% CI (1.56, 4.93), P = 0.002; MD electrochemiluminescence = 0.53, 95% CI (0.11, 0.96), P = 0.01; MD HAMD = 8.91, 95% CI (5.43, 12.38), P < 0.001; MD EPDS = 0.64, 95% CI (0.22, 1.05), P = 0.003]. Conclusion: The existing evidence suggests that there is a certain correlation between salivary cortisol level and depressive mood, and that salivary cortisol level is higher in the morning than at other times, and its level is influenced by different measurement methods. In addition, there is a certain positive correlation between the degree of depression and salivary cortisol level.