Plasminogen Activator Inhibitor - 1 Serum level in patients with major depressive disorder vs. healthy controls: a systematic review and meta-analysis.

BACKGROUND Major depressive disorder (MDD) is a severe health condition that affects millions of people worldwide. Etiologically, several factors may play a role in its development. Previous studies reported elevated plasminogen activator inhibitor-1 levels in patients with depression, suggesting that plasminogen activator inhibitor-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 the studies in which the level of plasminogen activator inhibitor-1 was reported in subjects with MDD. Subsequently we used RevMan 5.3 for performing a meta-analysis of data extracted from the included studies using PRISMA and PICO criteria for the search and analysis. RESULTS Six studies that reported mean ± SD were included in the analysis with 507 MDD patients and 3453 controls. The overall standardized mean difference was 0.27 (95% CI 0.01, 0.53). Plasminogen activator inhibitor-1 serum level was 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 in the studies showed through the Inconsistency test (I2 = 72%), and the Chi-Square test (X2 = 18.32; p = 0.003). CONCLUSIONS This systematic review and meta-analysis showed that MDD might be related to elevated plasminogen activator inhibitor-1 levels. We propose larger prospective clinical studies to further investigate this clinical correlation and validate those observations' clinical significance.