帕金森病中的血清胰岛素样生长因子-1（IGF-1）：一项系统综述与荟萃分析。
完整摘要 · 中文译文
背景：帕金森病（PD）是一种常见的神经退行性疾病，以进行性运动症状和非运动症状为特征。胰岛素样生长因子-1（IGF-1）是一种神经保护性激素，已被提出作为PD的潜在生物标志物。 目的：本研究旨在评估帕金森病患者（PwPD）与健康对照者之间血清IGF-1水平的差异，并评估其与症状严重程度的关联。 方法：我们于2024年12月7日对PubMed、Embase和Web of Science进行了系统检索。纳入比较PwPD与健康对照者血清IGF-1的观察性研究，或评估其与PD症状关联的研究。采用纽卡斯尔-渥太华量表评估研究质量。采用随机效应荟萃分析合并IGF-1水平的均数差（MD），并综合运动症状的相关系数。非运动症状关联采用效应方向图进行分析。 结果：共纳入18项研究，涉及2，480名参与者（1，465例PwPD；1，015例对照者）。PwPD的血清IGF-1水平显著高于对照者（MD：21.3 ng/mL；95CI：11.49，31.12；p < 0.001）。在早期/晚期及未用药/已治疗的PwPD中，IGF-1升高保持一致，亚组间无显著差异。对五项研究（413例PwPD）的荟萃分析显示，IGF-1水平与运动症状严重程度呈负相关（r = -0.35；95% CI：-0.53，-0.08；p < 0.01），尽管各单项研究结果存在异质性，且证据确定性较低。非运动症状亦未显示一致的关联。 结论 IONS：帕金森病（PwPD）患者血清胰岛素样生长因子-1（IGF-1）水平升高，且可能与运动症状严重程度呈负相关。IGF-1与非运动症状的关系尚不明确，需进一步研究。需要纵向研究来确定IGF-1作为帕金森病生物标志物的效用。
完整摘要 · 英文原文
BACKGROUND: Parkinson's disease (PD) is a common neurodegenerative disorder characterized by progressive motor and non-motor symptoms. Insulin-like Growth Factor-1 (IGF-1), a neuroprotective hormone, has been proposed as a potential biomarker in PD. OBJECTIVES: This study aimed to evaluate differences in serum IGF-1 levels between people with PD (PwPD) and healthy controls, and to assess associations with symptom severity. METHODS: We conducted a systematic search of PubMed, Embase, and Web of Science on December 7, 2024. Observational studies comparing serum IGF-1 in PwPD and healthy controls, or assessing its associations with PD symptoms, were included. Study quality was evaluated using the Newcastle-Ottawa Scale. A random-effects meta-analysis pooled mean differences (MD) in IGF-1 levels, and correlation coefficients were synthesized for motor symptoms. Non-motor symptom associations were analyzed using effect direction plots. RESULTS: Eighteen studies with 2,480 participants (1,465 PwPD; 1,015 controls) were included. PwPD had significantly higher serum IGF-1 levels than controls (MD: 21.3 ng/mL; 95CI: 11.49, 31.12; p < 0.001). Elevated IGF-1 was consistent across early/late-stage and drug-naïve/treated PwPD, with no significant subgroup differences. Meta-analysis of five studies (413 PwPD) showed an inverse correlation between IGF-1 levels and motor symptom severity (r = -0.35; 95% CI: -0.53, -0.08; p < 0.01), although individual study findings were heterogeneous, and the certainty of evidence was low. Non-motor symptoms also showed no consistent associations. CONCLUSIONS: PwPD exhibit elevated serum IGF-1 levels and may be inversely associated with motor symptom severity. IGF-1's relationship with non-motor symptoms remains unclear and requires further study. Longitudinal research is needed to determine IGF-1's utility as a PD biomarker.