Association of Microvascular Dysfunction With Late-Life Depression: A Systematic Review and Meta-analysis

Marnix J M van Agtmaal, Alfons J H M Houben, Frans Pouwer, Coen D A Stehouwer, Miranda T Schram

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Resumé

Importance: The etiologic factors of late-life depression are still poorly understood. Recent evidence suggests that microvascular dysfunction is associated with depression, which may have implications for prevention and treatment. However, this association has not been systematically reviewed.

Objective: To examine the associations of peripheral and cerebral microvascular dysfunction with late-life depression.

Data Sources: A systematic literature search was conducted in MEDLINE and EMBASE for and longitudinal studies published since inception to October 16, 2016, that assessed the associations between microvascular dysfunction and depression.

Study Selection: Three independent researchers performed the study selection based on consensus. Inclusion criteria were a study population 40 years of age or older, a validated method of detecting depression, and validated measures of microvascular function.

Data Extraction and Synthesis: This systematic review and meta-analysis has been registered at PROSPERO (CRD42016049158) and is reported in accordance with the PRISMA and MOOSE guidelines. Data extraction was performed by an independent researcher.

Main Outcomes and Measures: The following 5 estimates of microvascular dysfunction were considered in participants with or without depression: plasma markers of endothelial function, albuminuria, measurements of skin and muscle microcirculation, retinal arteriolar and venular diameter, and markers for cerebral small vessel disease. Data are reported as pooled odds ratios (ORs) by use of the generic inverse variance method with the use of random-effects models.

Results: A total of 712 studies were identified; 48 were included in the meta-analysis, of which 8 described longitudinal data. Data from 43 600 participants, 9203 individuals with depression, and 72 441 person-years (mean follow-up, 3.7 years) were available. Higher levels of plasma endothelial biomarkers (soluble intercellular adhesion molecule-1: OR, 1.58; 95% CI, 1.28-1.96), white matter hyperintensities (OR, 1.29; 95% CI, 1.19-1.39), cerebral microbleeds (OR, 1.18; 95% CI, 1.03-1.34), and cerebral (micro)infarctions (OR, 1.30; 95% CI, 1.21-1.39) were associated with depression. Among the studies available, no significant associations of albuminuria and retinal vessel diameters with depression were reported. Longitudinal data showed a significant association of white matter hyperintensities with incident depression (OR, 1.19; 95% CI, 1.09-1.30).

Conclusions and Relevance: This meta-analysis shows that both the peripheral and cerebral forms of microvascular dysfunction are associated with higher odds of (incident) late-life depression. This finding may have clinical implications because microvascular dysfunction might provide a potential target for the prevention and treatment of depression.

OriginalsprogEngelsk
TidsskriftJAMA Psychiatry
Vol/bind74
Udgave nummer4
Sider (fra-til)729-739
ISSN0003-990X
DOI
StatusUdgivet - 2017

Fingeraftryk

Meta-Analysis
Odds Ratio
Albuminuria
Research Personnel
Information Storage and Retrieval
Intercellular Adhesion Molecule-1
Microcirculation
MEDLINE
Longitudinal Studies
Outcome Assessment (Health Care)
Guidelines
Muscles
Skin
Population
White Matter

Citer dette

van Agtmaal, Marnix J M ; Houben, Alfons J H M ; Pouwer, Frans ; Stehouwer, Coen D A ; Schram, Miranda T. / Association of Microvascular Dysfunction With Late-Life Depression : A Systematic Review and Meta-analysis. I: JAMA Psychiatry. 2017 ; Bind 74, Nr. 4. s. 729-739.
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abstract = "Importance: The etiologic factors of late-life depression are still poorly understood. Recent evidence suggests that microvascular dysfunction is associated with depression, which may have implications for prevention and treatment. However, this association has not been systematically reviewed.Objective: To examine the associations of peripheral and cerebral microvascular dysfunction with late-life depression.Data Sources: A systematic literature search was conducted in MEDLINE and EMBASE for and longitudinal studies published since inception to October 16, 2016, that assessed the associations between microvascular dysfunction and depression.Study Selection: Three independent researchers performed the study selection based on consensus. Inclusion criteria were a study population 40 years of age or older, a validated method of detecting depression, and validated measures of microvascular function.Data Extraction and Synthesis: This systematic review and meta-analysis has been registered at PROSPERO (CRD42016049158) and is reported in accordance with the PRISMA and MOOSE guidelines. Data extraction was performed by an independent researcher.Main Outcomes and Measures: The following 5 estimates of microvascular dysfunction were considered in participants with or without depression: plasma markers of endothelial function, albuminuria, measurements of skin and muscle microcirculation, retinal arteriolar and venular diameter, and markers for cerebral small vessel disease. Data are reported as pooled odds ratios (ORs) by use of the generic inverse variance method with the use of random-effects models.Results: A total of 712 studies were identified; 48 were included in the meta-analysis, of which 8 described longitudinal data. Data from 43 600 participants, 9203 individuals with depression, and 72 441 person-years (mean follow-up, 3.7 years) were available. Higher levels of plasma endothelial biomarkers (soluble intercellular adhesion molecule-1: OR, 1.58; 95{\%} CI, 1.28-1.96), white matter hyperintensities (OR, 1.29; 95{\%} CI, 1.19-1.39), cerebral microbleeds (OR, 1.18; 95{\%} CI, 1.03-1.34), and cerebral (micro)infarctions (OR, 1.30; 95{\%} CI, 1.21-1.39) were associated with depression. Among the studies available, no significant associations of albuminuria and retinal vessel diameters with depression were reported. Longitudinal data showed a significant association of white matter hyperintensities with incident depression (OR, 1.19; 95{\%} CI, 1.09-1.30).Conclusions and Relevance: This meta-analysis shows that both the peripheral and cerebral forms of microvascular dysfunction are associated with higher odds of (incident) late-life depression. This finding may have clinical implications because microvascular dysfunction might provide a potential target for the prevention and treatment of depression.",
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Association of Microvascular Dysfunction With Late-Life Depression : A Systematic Review and Meta-analysis. / van Agtmaal, Marnix J M; Houben, Alfons J H M; Pouwer, Frans; Stehouwer, Coen D A; Schram, Miranda T.

I: JAMA Psychiatry, Bind 74, Nr. 4, 2017, s. 729-739.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

TY - JOUR

T1 - Association of Microvascular Dysfunction With Late-Life Depression

T2 - A Systematic Review and Meta-analysis

AU - van Agtmaal, Marnix J M

AU - Houben, Alfons J H M

AU - Pouwer, Frans

AU - Stehouwer, Coen D A

AU - Schram, Miranda T

PY - 2017

Y1 - 2017

N2 - Importance: The etiologic factors of late-life depression are still poorly understood. Recent evidence suggests that microvascular dysfunction is associated with depression, which may have implications for prevention and treatment. However, this association has not been systematically reviewed.Objective: To examine the associations of peripheral and cerebral microvascular dysfunction with late-life depression.Data Sources: A systematic literature search was conducted in MEDLINE and EMBASE for and longitudinal studies published since inception to October 16, 2016, that assessed the associations between microvascular dysfunction and depression.Study Selection: Three independent researchers performed the study selection based on consensus. Inclusion criteria were a study population 40 years of age or older, a validated method of detecting depression, and validated measures of microvascular function.Data Extraction and Synthesis: This systematic review and meta-analysis has been registered at PROSPERO (CRD42016049158) and is reported in accordance with the PRISMA and MOOSE guidelines. Data extraction was performed by an independent researcher.Main Outcomes and Measures: The following 5 estimates of microvascular dysfunction were considered in participants with or without depression: plasma markers of endothelial function, albuminuria, measurements of skin and muscle microcirculation, retinal arteriolar and venular diameter, and markers for cerebral small vessel disease. Data are reported as pooled odds ratios (ORs) by use of the generic inverse variance method with the use of random-effects models.Results: A total of 712 studies were identified; 48 were included in the meta-analysis, of which 8 described longitudinal data. Data from 43 600 participants, 9203 individuals with depression, and 72 441 person-years (mean follow-up, 3.7 years) were available. Higher levels of plasma endothelial biomarkers (soluble intercellular adhesion molecule-1: OR, 1.58; 95% CI, 1.28-1.96), white matter hyperintensities (OR, 1.29; 95% CI, 1.19-1.39), cerebral microbleeds (OR, 1.18; 95% CI, 1.03-1.34), and cerebral (micro)infarctions (OR, 1.30; 95% CI, 1.21-1.39) were associated with depression. Among the studies available, no significant associations of albuminuria and retinal vessel diameters with depression were reported. Longitudinal data showed a significant association of white matter hyperintensities with incident depression (OR, 1.19; 95% CI, 1.09-1.30).Conclusions and Relevance: This meta-analysis shows that both the peripheral and cerebral forms of microvascular dysfunction are associated with higher odds of (incident) late-life depression. This finding may have clinical implications because microvascular dysfunction might provide a potential target for the prevention and treatment of depression.

AB - Importance: The etiologic factors of late-life depression are still poorly understood. Recent evidence suggests that microvascular dysfunction is associated with depression, which may have implications for prevention and treatment. However, this association has not been systematically reviewed.Objective: To examine the associations of peripheral and cerebral microvascular dysfunction with late-life depression.Data Sources: A systematic literature search was conducted in MEDLINE and EMBASE for and longitudinal studies published since inception to October 16, 2016, that assessed the associations between microvascular dysfunction and depression.Study Selection: Three independent researchers performed the study selection based on consensus. Inclusion criteria were a study population 40 years of age or older, a validated method of detecting depression, and validated measures of microvascular function.Data Extraction and Synthesis: This systematic review and meta-analysis has been registered at PROSPERO (CRD42016049158) and is reported in accordance with the PRISMA and MOOSE guidelines. Data extraction was performed by an independent researcher.Main Outcomes and Measures: The following 5 estimates of microvascular dysfunction were considered in participants with or without depression: plasma markers of endothelial function, albuminuria, measurements of skin and muscle microcirculation, retinal arteriolar and venular diameter, and markers for cerebral small vessel disease. Data are reported as pooled odds ratios (ORs) by use of the generic inverse variance method with the use of random-effects models.Results: A total of 712 studies were identified; 48 were included in the meta-analysis, of which 8 described longitudinal data. Data from 43 600 participants, 9203 individuals with depression, and 72 441 person-years (mean follow-up, 3.7 years) were available. Higher levels of plasma endothelial biomarkers (soluble intercellular adhesion molecule-1: OR, 1.58; 95% CI, 1.28-1.96), white matter hyperintensities (OR, 1.29; 95% CI, 1.19-1.39), cerebral microbleeds (OR, 1.18; 95% CI, 1.03-1.34), and cerebral (micro)infarctions (OR, 1.30; 95% CI, 1.21-1.39) were associated with depression. Among the studies available, no significant associations of albuminuria and retinal vessel diameters with depression were reported. Longitudinal data showed a significant association of white matter hyperintensities with incident depression (OR, 1.19; 95% CI, 1.09-1.30).Conclusions and Relevance: This meta-analysis shows that both the peripheral and cerebral forms of microvascular dysfunction are associated with higher odds of (incident) late-life depression. This finding may have clinical implications because microvascular dysfunction might provide a potential target for the prevention and treatment of depression.

KW - Journal Article

U2 - 10.1001/jamapsychiatry.2017.0984

DO - 10.1001/jamapsychiatry.2017.0984

M3 - Review

C2 - 28564681

VL - 74

SP - 729

EP - 739

JO - Archives of General Psychiatry

JF - Archives of General Psychiatry

SN - 0003-990X

IS - 4

ER -