Plasma biomarkers of endothelial function in people with depressive disorder: A systematic review and meta-analysis

The objective of this study is to conduct a literature review and summarize existing research comparing levels of blood markers of endothelial function in people with depression with controls. We searched major databases (Embase, PubMed, Web of Science, and PsycINFO) from inception to 23.07.2023, for studies comparing endothelial function blood markers in people with depression and controls including intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), monocyte chemoattractant protein-1 (MCP-1), and sE-selectin. Comparative random effects meta-analysis, calculating standardized mean differences in levels of sICAM-1, sVCAM-1, MCP-1, and sE-selectin between depressed and controls were conducted. Study protocol was registered with PROSPERO (CRD42020222487). Nineteen studies including 10,566 participants [1322 depressed (mean age = 49.1 years, 63 % females) and 9239 controls (mean age = 52.3 years, 57.5 % females)] were included. People with depression had higher levels of sICAM-1 (SMD = 0.98, 95 % CI: 0.52; 1.44, P < 0.001) and MCP-1 (SMD = 0.37, 95 % CI: 0.01; 0.72, P = 0.04) than controls. There was a small difference on sVCAM-1 (k = 10, SMD = 0.215, 95%CI: 0.013; 0.417, p = 0.04), but no difference in levels of E-selectin between people with depression and controls (k = 5,SMD = 0.21, 95%CI:-0.09;0.52, P = 0.17). Subgroup analyzes demonstrated that people with depression and comorbid chronic illnesses, such as diabetes, have higher levels of sICAM-1 than people with depression without comorbid chronic illness. Mean age moderate the difference in sICAM-1 levels between depressed and controls (SMD = 0.01, 95%CI:-0.05;-0.02,P < 0.001, R² = 0.61). Our findings suggest that people with depression exhibit increased levels of endothelial activation markers compared to controls, suggesting an endothelial dysfunction among this population.