title: Clinical significance of decreased protein expression of dehydroepiandrosterone sulfate in the development of depression: a meta-analysis.
abstract: BACKGROUND
  Previous evidence has shown that adrenal androgens, dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) have significant functions related to the control of mood, affect, and anxiety. Changes in their expression levels are reportedly related to several psychiatric disorders. The objective of this meta-analysis was to explore the role of DHEAS protein expression in patients with depression.
  
  
  METHODS
  Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine (CBM) and China National Knowledge Infrastructure (CNKI) were electronically searched. Only those studies that analyzing DHEAS expression in depression patients were considered eligible for inclusion. Standardized mean differences (SMDs) were pooled with a 95% confidence interval (CI) in accordance with the random-effects model.
  
  
  RESULTS
  Ten clinical case-control studies, consisting of 4496 subjects (493 patients with depression and 4003 healthy controls) were incorporated for analysis. Results revealed a lower DHEAS protein expression level in patients with depression than in normal controls (SMD=0.17, 95% CI: 0.06-0.27, P=0.002). Ethnicity-stratified analysis indicated that lower levels of DHEAS expression in depression patients were not observed in Caucasians or Asians (both P>0.05).
  
  
  CONCLUSIONS
  Elevated DHEAS protein expression may be correlated with the biological pathophysiology of depression, indicating that checking DHEAS levels and administration of DHEAS could contribute to the effective treatment of depression.
authors.affiliation: Department of Psychology, Qiqihar Mental Health Center, Qiqihar 161000, PR China. Electronic address: huqiang0704@163.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Institute of Forensic Science, Ministry of Justice, Shanghai Key Lab of Forensic Medicine, Shanghai 200063, PR China. Electronic address: tmac1zsy@163.com.
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai 200000, PR China.
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Psychology, Qiqihar Mental Health Center, Qiqihar 161000, PR China.
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Shanghai Mental Health Center, Shanghai 200000, PR China.
authors.forename: Dian-Ming
authors.initials: DM
authors.lastname: Zhu
authors.affiliation: Center for the Treatment and Study of Anxiety, University of Pennsylva, Philadelphia 19104, United States.
authors.forename: Yin-Yin
authors.initials: YY
authors.lastname: Zang
mesh_terms: D016022:Case-Control Studies; D019314:Dehydroepiandrosterone Sulfate / Q000378:metabolism*; D003863:Depression / Q000378:metabolism*; D006801:Humans
chemical_list: D019314:Dehydroepiandrosterone Sulfate
keywords: Dehydroepiandrosterone sulfate protein; Depression; Meta-analysis