Systematic review of sex differences in the relationship between hormones and depression in HIV.
Systematic review of sex differences in the relationship between hormones and depression in HIV.
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DOI：
10.1016/j.psyneuen.2022.105665
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发表时间：
2022-04
影响因子：
3.7
通讯作者：
Lofgren SM
中科院分区：
文献类型：
--
作者：
Turk MC;Bakker CJ;Spencer SM;Lofgren SM
重性抑郁障碍是人类免疫缺陷病毒（HIV）最常见的神经精神共病，女性在一般人群和HIV感染者中更常见。艾滋病毒感染者的抑郁率是普通人群的三倍。神经内分泌和炎症通路中生物标志物的差异是艾滋病毒感染者，特别是生物学女性抑郁症患病率增加的一种可能解释。因此，我们的目的是进行系统评价，确定导致男性与女性艾滋病毒感染者抑郁症的神经内分泌因素的差异。对8个数据库进行了全面检索，然后进行了标题和摘要筛选，随后由两名独立研究人员进行了全文筛选。完成了偏倚风险评估。26篇全文文章被纳入综述。抑郁症和神经内分泌标志物水平之间的显着相关性被发现皮质醇（两种性别），睾酮（仅在男性），催产素（仅在女性中测试），雌二醇（仅在女性中）。催乳素、脱氢表雄酮（DHEAS）或性激素结合球蛋白（SHBG）与抑郁症之间无显著相关性。几乎所有的研究都只包括男性或女性，并且没有直接比较两种性别之间的神经内分泌标志物。一项研究发现，女性的皮质醇水平与抑郁评分之间的相关性比男性更强。神经内分泌系统在大脑中高度活跃，在精神疾病的发展和持续中非常重要。鉴于艾滋病毒可以直接和间接地影响激素信号，它可能导致艾滋病毒感染者抑郁症的高发病率。然而，很少有研究探讨抑郁症和艾滋病病毒中的神经活性激素，也没有这种联系在性别之间可能存在差异。需要在这一领域进行更多高质量的研究，以进一步探索这种联系，并为可能的治疗途径提供信息。
Major depressive disorder is the most common neuropsychiatric comorbidity of human immunodeficiency virus (HIV), and women are more frequently affected in the general population and among those with HIV. The rate of depression in HIV is three times higher than the general population. Differences in biomarkers in neuroendocrine and inflammatory pathways are one possible explanation for the increased prevalence of depression in individuals with HIV, especially biological women. Therefore, we aimed to perform a systematic review identifying differences in neuroendocrine factors leading to depression in men versus women with HIV. A comprehensive search of 8 databases was performed, followed by title and abstract screening and later full-text screening by two independent researchers. A risk of bias assessment was completed. Twenty-six full-text articles were included in the review. Significant correlations between depression and neuroendocrine marker levels were found for cortisol (both sexes), testosterone (only in men), oxytocin (only tested in women), and estradiol (only in women). No significant correlation between depression and hormone level was found for prolactin, dehydroepiandrosterone (DHEAS), or sex hormone binding globulin (SHBG). Nearly all studies included only men or women and did not directly compare neuroendocrine markers between the two sexes. One study found that the correlation between cortisol levels and depression scores was stronger in women than men. Neuroendocrine systems are highly active in the brain and important in the development and persistence of mental illness. Given that HIV can, directly and indirectly, impact hormone signaling, it is likely contributing to the high rate of depression in individuals with HIV. However, few studies explore neuroactive hormones in depression and HIV, nor how this connection may differ between the sexes. More high-quality research is needed in this area to explore the link further and inform possible avenues of treatment.
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