Key result
Major depressive disorder was associated with significantly higher serum PAI-1 levels compared to healthy controls (SMD 0.27; 95% CI 0.01-0.53; p=0.04).
Why the study?
Previous studies reported elevated plasminogen activator inhibitor-1 (PAI-1) levels in depression, suggesting PAI-1 might be linked to the etiology of major depressive disorder.
Are serum PAI-1 levels elevated in patients with major depressive disorder compared to healthy controls?
Meta-Analysis (n=3,960)
Are serum PAI-1 levels elevated in patients with major depressive disorder compared to healthy controls?
Standardized Mean Difference: 0.27 (95% CI 0.01–0.53)
p-value: p=0.04
Patients with major depressive disorder have significantly elevated serum PAI-1 levels compared to healthy controls, suggesting a potential link between depression and thrombotic risk.
INTRODUCTION: Major depressive disorder (MDD) is a severe mental health condition that affects millions of people worldwide. Etiologically, several factors may play a role in its development. Previous studies have reported elevated plasminogen activator inhibitor-1 (PAI-1) levels in patients with depression, suggesting that PAI-1 levels might be linked to the etiology of MDD. METHODS: We systematically searched the following online databases: MEDLINE, Scopus, and Web of Science up to September 10, 2020, to identify studies in which PAI-1 levels were reported in subjects with MDD. Subsequently we used RevMan 5.3 to perform a meta-analysis of data extracted from the included studies using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PICO criteria for the search and analysis. RESULTS: Six studies that reported mean ± standard deviation (SD) were included in the analysis, with a total of 507 MDD patients and 3,453 controls. The overall standardized mean difference (SMD) was 0.27 (95% confidence interval [95% CI] 0.01-0.53). PAI-1 serum levels were 0.27 SDs higher in MDD patients than in controls. The test for overall effect was significant (z = 2.04, p = 0.04). Substantial heterogeneity was detected among the studies, demonstrated by the inconsistency test (I² = 72%) and the chi-square test (χ² = 18.32; p = 0.003). CONCLUSIONS: This systematic review and meta-analysis showed that MDD might be related to elevated PAI-1 levels. We propose larger prospective clinical studies to further investigate this clinical correlation and validate the clinical significance of these observations.
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Elsayed et al. (2021) conducted a meta-analysis in Major depressive disorder (n=3,960). Major depressive disorder vs. Healthy controls was evaluated on PAI-1 serum levels (SMD 0.27, 95% CI 0.01-0.53, p=0.04). Major depressive disorder was associated with significantly higher serum PAI-1 levels compared to healthy controls (SMD 0.27; 95% CI 0.01-0.53; p=0.04).
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