Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/22642 |
Resumo: | Depressive disorder, or depression, is a highly prevalent mood disorder and associated with an increased risk of developing cardiovascular disease. Endothelial dysfunction can be an early indicator of cardiovascular disease risk. However, there is still no consistency in the literature on how much people with depression have endothelial dysfunction and how much physical activity can moderate this association. The objectives of the dissertation were to review the literature and summarize the studies that compared the presence of endothelial dysfunction between people with depression versus people without depression and to explore whether physical activity moderates this association. A systematic review with comparative meta-analysis was carried out. The search for studies that evaluated endothelial function using the flow-mediated dilation technique (FMD) in people with depression and controls was carried out in four databases: PubMed, Embase, Web of Science and PsycINFO, from the beginning of the databases to February 27, 2020. Meta-analyzes of random effects were performed and heterogeneity was explored through meta-regressions and subgroup analyzes. the search resulted in a total of 5,188 studies and of these 9 were included because they met the inclusion criteria of the present study. These 9 studies included a total of 1,367 participants, with a median age of 39.8 years, with a median of 44.9% men. People with depression have 1.92% lower FMD (N=9, MD= -1,92, IC 95% -3,12 a -0,72, p<0,002, I2=93,31) when compared to controls. There is no difference in endothelium-independent vasodilation (N=7, MD= -0,691, IC 95% -1,790 a 0,408, p= 0,218, I2=61,5%). HDL levels, explored by meta-regression, explained 45% of the difference found. In the subgroup analyzes, people whose depression was confirmed by diagnostic instruments had impaired endothelial function when compared to controls, with a 3% less dilation (N= 4, MD= -3,339, IC= -5,415 a -1,264, p= 0,001, I2= 89,3). People with depressive symptoms have no difference in FMD when compared to controls. Still, in the studies that evaluated FMD in the first minute after release of the occlusion , there was a difference between depressed and controls (N= 5, MD=-3,090, IC= -4,777 a -1,404, p= 0,000, I2= 85,7). There is a difference in endothelial function when using the occlusion position in the distal forearm (N= 3, MD= -4,390, IC= -6,607 a -2,172, p= 0,000, I2= 80,1) and when using occlusion pressure between 250 to 300 mmHg (N= 4, MD= -2,445, IC= -4,274 a -0,616, p= 0,008, I2= 87,1). Conclusion: Individuals with depression have endothelial dysfunction when compared to controls. These findings may have clinical implications, as the reduction in FMD is an early marker of cardiovascular risk and can be a diagnostic strategy to enhance the care and attention to cardiovascular health of people with depression. |
id |
UFSM_b172b045e5b7736101e1b8b5bb6f3f44 |
---|---|
oai_identifier_str |
oai:repositorio.ufsm.br:1/22642 |
network_acronym_str |
UFSM |
network_name_str |
Biblioteca Digital de Teses e Dissertações do UFSM |
repository_id_str |
|
spelling |
2021-10-28T11:08:59Z2021-10-28T11:08:59Z2020-07-28http://repositorio.ufsm.br/handle/1/22642Depressive disorder, or depression, is a highly prevalent mood disorder and associated with an increased risk of developing cardiovascular disease. Endothelial dysfunction can be an early indicator of cardiovascular disease risk. However, there is still no consistency in the literature on how much people with depression have endothelial dysfunction and how much physical activity can moderate this association. The objectives of the dissertation were to review the literature and summarize the studies that compared the presence of endothelial dysfunction between people with depression versus people without depression and to explore whether physical activity moderates this association. A systematic review with comparative meta-analysis was carried out. The search for studies that evaluated endothelial function using the flow-mediated dilation technique (FMD) in people with depression and controls was carried out in four databases: PubMed, Embase, Web of Science and PsycINFO, from the beginning of the databases to February 27, 2020. Meta-analyzes of random effects were performed and heterogeneity was explored through meta-regressions and subgroup analyzes. the search resulted in a total of 5,188 studies and of these 9 were included because they met the inclusion criteria of the present study. These 9 studies included a total of 1,367 participants, with a median age of 39.8 years, with a median of 44.9% men. People with depression have 1.92% lower FMD (N=9, MD= -1,92, IC 95% -3,12 a -0,72, p<0,002, I2=93,31) when compared to controls. There is no difference in endothelium-independent vasodilation (N=7, MD= -0,691, IC 95% -1,790 a 0,408, p= 0,218, I2=61,5%). HDL levels, explored by meta-regression, explained 45% of the difference found. In the subgroup analyzes, people whose depression was confirmed by diagnostic instruments had impaired endothelial function when compared to controls, with a 3% less dilation (N= 4, MD= -3,339, IC= -5,415 a -1,264, p= 0,001, I2= 89,3). People with depressive symptoms have no difference in FMD when compared to controls. Still, in the studies that evaluated FMD in the first minute after release of the occlusion , there was a difference between depressed and controls (N= 5, MD=-3,090, IC= -4,777 a -1,404, p= 0,000, I2= 85,7). There is a difference in endothelial function when using the occlusion position in the distal forearm (N= 3, MD= -4,390, IC= -6,607 a -2,172, p= 0,000, I2= 80,1) and when using occlusion pressure between 250 to 300 mmHg (N= 4, MD= -2,445, IC= -4,274 a -0,616, p= 0,008, I2= 87,1). Conclusion: Individuals with depression have endothelial dysfunction when compared to controls. These findings may have clinical implications, as the reduction in FMD is an early marker of cardiovascular risk and can be a diagnostic strategy to enhance the care and attention to cardiovascular health of people with depression.O transtorno depressivo maior, ou depressão, é um transtorno do humor altamente prevalente e associado a um risco aumentado de desenvolvimento de doenças cardiovasculares. A disfunção endotelial pode ser um indicador precoce de risco para doenças cardiovasculares. No entanto, ainda não há consistência na literatura sobre o quanto pessoas com depressão apresentam disfunção endotelial e nem o quanto a atividade física pode moderar essa associação. Os objetivos da dissertação foram revisar a literatura e sumarizar os estudos que compararam a presença da disfunção endotelial entre pessoas com depressão versus pessoas sem depressão e explorar se a atividade física é um moderador dessa associação. Realizou-se uma revisão sistemática com meta-análise comparativa. A busca por estudos que avaliaram a função endotelial pela técnica de dilatação mediada pelo fluxo (FMD) em pessoas com depressão e controles foi realizada em quatro bases de dados: PubMed, Embase, Web of Science e PsycINFO, do começo das bases de dados até 27 de fevereiro de 2020. Meta-análises de efeitos aleatórios foram realizadas e a heterogeneidade foi explorada através de metarregressões e análises de subgrupos. A busca resultou em um total de 5.188 estudos e desses 9 foram incluídos por atenderem os critérios de inclusão do presente estudo. Esses 9 estudos incluíram um total de 1.367 participantes, com mediana de idade de 39,8 anos, e compostos por uma média de 45,7% homens. Pessoas com depressão apresentam FMD 1,92% menor (N=9, MD= -1,92, IC 95% -3,12 a -0,72, p<0,002, I2=93,31) quando comparadas a controles. Não há diferença na vasodilatação endotélio-independente entre pessoas com e sem depressão (N=7, MD= -0,691, IC 95% -1,790 a 0,408, p= 0,218, I2=61,5%). Os níveis de HDL, explorados por metarregressão, explicaram 45% da diferença encontrada. Nas análises de subgrupo, pessoas que tiveram a depressão confirmada por instrumentos diagnósticos apresentaram função endotelial prejudicada quando comparadas a controles, com uma dilatação 3% menor (N= 4, MD= -3,339, IC= -5,415 a -1,264, p= 0,001, I2= 89,3). Pessoas com sintomas depressivos não apresentam diferença na FMD quando comparadas a controles. Ainda, nos estudos que avaliaram a FMD no primeiro minuto após liberação da oclusão houve diferença entre deprimidos e controles (N= 5, MD=-3,090, IC= -4,777 a -1,404, p= 0,000, I2= 85,7). Há diferença na função endotelial quando utilizada posição de oclusão no antebraço distal (N= 3, MD= -4,390, IC= -6,607 a -2,172, p= 0,000, I2= 80,1) e quando se utiliza pressão de oclusão entre 250 e 300 mmHg (N= 4, MD= -2,445, IC= -4,274 a -0,616, p= 0,008, I2= 87,1). Conclusão: Indivíduos com depressão apresentam disfunção endotelial quando comparados a controles. Estes achados podem ter implicação clínica, pois a redução da FMD é marcador precoce de risco cardiovascular e pode ser uma estratégia diagnóstica para potencializar o cuidado e a atenção à saúde cardiovascular de pessoas com depressão.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Reabilitação FuncionalUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessTranstorno depressivo maiorDepressãoEndotélioDisfunção endotelialMajor depressive disorderDepressionEndotheliumEndothelial dysfunctionCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALAtividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análisePhysical activity as a moderator of endothelial dysfunction in people with depressive disorder: a systematic review with meta-analysisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisSchuch, Felipe Barretohttp://lattes.cnpq.br/6306568661892387Moraes, Daniel Umpierre deSilva, Cristiano Tschiedel Belem dahttp://lattes.cnpq.br/0875834895324035Waclawovsky, Aline Josiane4008000000086006006006006003a313506-3a91-438f-bb1c-afd5e433ac8e485c8e13-ec8a-4b6c-ab2f-09b633ba858b64d21f7a-ff73-4a40-9b81-02c438475c1cca1d376d-9a16-4fb9-a5c4-002fece9de03reponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdfDIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdfDissertaçãoapplication/pdf1245729http://repositorio.ufsm.br/bitstream/1/22642/1/DIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf1cb6363ace637716bf1b206edd61a895MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/22642/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-816http://repositorio.ufsm.br/bitstream/1/22642/3/license.txtf8fcb28efb1c8cf0dc096bec902bf4c4MD53TEXTDIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.txtDIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.txtExtracted texttext/plain105281http://repositorio.ufsm.br/bitstream/1/22642/4/DIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.txt4ae529d55e28add84d3518e3d78cf2e9MD54THUMBNAILDIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.jpgDIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.jpgIM Thumbnailimage/jpeg4871http://repositorio.ufsm.br/bitstream/1/22642/5/DIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.jpg1e6847d2147afff4a3f4d7ae242c8ae4MD551/226422021-10-29 03:02:46.6oai:repositorio.ufsm.br:1/22642Q3JlYXRpdmUgQ29tbW9ucw==Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2021-10-29T06:02:46Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
dc.title.alternative.eng.fl_str_mv |
Physical activity as a moderator of endothelial dysfunction in people with depressive disorder: a systematic review with meta-analysis |
title |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
spellingShingle |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise Waclawovsky, Aline Josiane Transtorno depressivo maior Depressão Endotélio Disfunção endotelial Major depressive disorder Depression Endothelium Endothelial dysfunction CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
title_full |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
title_fullStr |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
title_full_unstemmed |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
title_sort |
Atividade física como moderador da disfunção endotelial em pessoas com transtorno depressivo: uma revisão sistemática com meta-análise |
author |
Waclawovsky, Aline Josiane |
author_facet |
Waclawovsky, Aline Josiane |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Schuch, Felipe Barreto |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/6306568661892387 |
dc.contributor.referee1.fl_str_mv |
Moraes, Daniel Umpierre de |
dc.contributor.referee2.fl_str_mv |
Silva, Cristiano Tschiedel Belem da |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0875834895324035 |
dc.contributor.author.fl_str_mv |
Waclawovsky, Aline Josiane |
contributor_str_mv |
Schuch, Felipe Barreto Moraes, Daniel Umpierre de Silva, Cristiano Tschiedel Belem da |
dc.subject.por.fl_str_mv |
Transtorno depressivo maior Depressão Endotélio Disfunção endotelial |
topic |
Transtorno depressivo maior Depressão Endotélio Disfunção endotelial Major depressive disorder Depression Endothelium Endothelial dysfunction CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Major depressive disorder Depression Endothelium Endothelial dysfunction |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Depressive disorder, or depression, is a highly prevalent mood disorder and associated with an increased risk of developing cardiovascular disease. Endothelial dysfunction can be an early indicator of cardiovascular disease risk. However, there is still no consistency in the literature on how much people with depression have endothelial dysfunction and how much physical activity can moderate this association. The objectives of the dissertation were to review the literature and summarize the studies that compared the presence of endothelial dysfunction between people with depression versus people without depression and to explore whether physical activity moderates this association. A systematic review with comparative meta-analysis was carried out. The search for studies that evaluated endothelial function using the flow-mediated dilation technique (FMD) in people with depression and controls was carried out in four databases: PubMed, Embase, Web of Science and PsycINFO, from the beginning of the databases to February 27, 2020. Meta-analyzes of random effects were performed and heterogeneity was explored through meta-regressions and subgroup analyzes. the search resulted in a total of 5,188 studies and of these 9 were included because they met the inclusion criteria of the present study. These 9 studies included a total of 1,367 participants, with a median age of 39.8 years, with a median of 44.9% men. People with depression have 1.92% lower FMD (N=9, MD= -1,92, IC 95% -3,12 a -0,72, p<0,002, I2=93,31) when compared to controls. There is no difference in endothelium-independent vasodilation (N=7, MD= -0,691, IC 95% -1,790 a 0,408, p= 0,218, I2=61,5%). HDL levels, explored by meta-regression, explained 45% of the difference found. In the subgroup analyzes, people whose depression was confirmed by diagnostic instruments had impaired endothelial function when compared to controls, with a 3% less dilation (N= 4, MD= -3,339, IC= -5,415 a -1,264, p= 0,001, I2= 89,3). People with depressive symptoms have no difference in FMD when compared to controls. Still, in the studies that evaluated FMD in the first minute after release of the occlusion , there was a difference between depressed and controls (N= 5, MD=-3,090, IC= -4,777 a -1,404, p= 0,000, I2= 85,7). There is a difference in endothelial function when using the occlusion position in the distal forearm (N= 3, MD= -4,390, IC= -6,607 a -2,172, p= 0,000, I2= 80,1) and when using occlusion pressure between 250 to 300 mmHg (N= 4, MD= -2,445, IC= -4,274 a -0,616, p= 0,008, I2= 87,1). Conclusion: Individuals with depression have endothelial dysfunction when compared to controls. These findings may have clinical implications, as the reduction in FMD is an early marker of cardiovascular risk and can be a diagnostic strategy to enhance the care and attention to cardiovascular health of people with depression. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-07-28 |
dc.date.accessioned.fl_str_mv |
2021-10-28T11:08:59Z |
dc.date.available.fl_str_mv |
2021-10-28T11:08:59Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/22642 |
url |
http://repositorio.ufsm.br/handle/1/22642 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.cnpq.fl_str_mv |
400800000008 |
dc.relation.confidence.fl_str_mv |
600 600 600 600 600 |
dc.relation.authority.fl_str_mv |
3a313506-3a91-438f-bb1c-afd5e433ac8e 485c8e13-ec8a-4b6c-ab2f-09b633ba858b 64d21f7a-ff73-4a40-9b81-02c438475c1c ca1d376d-9a16-4fb9-a5c4-002fece9de03 |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Reabilitação Funcional |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações do UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Biblioteca Digital de Teses e Dissertações do UFSM |
collection |
Biblioteca Digital de Teses e Dissertações do UFSM |
bitstream.url.fl_str_mv |
http://repositorio.ufsm.br/bitstream/1/22642/1/DIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf http://repositorio.ufsm.br/bitstream/1/22642/2/license_rdf http://repositorio.ufsm.br/bitstream/1/22642/3/license.txt http://repositorio.ufsm.br/bitstream/1/22642/4/DIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.txt http://repositorio.ufsm.br/bitstream/1/22642/5/DIS_PPGRF_2020_WACLAWOVSKY_ALINE.pdf.jpg |
bitstream.checksum.fl_str_mv |
1cb6363ace637716bf1b206edd61a895 4460e5956bc1d1639be9ae6146a50347 f8fcb28efb1c8cf0dc096bec902bf4c4 4ae529d55e28add84d3518e3d78cf2e9 1e6847d2147afff4a3f4d7ae242c8ae4 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
_version_ |
1801485234140610560 |