The Associations of Serum Osteocalcin and Cortisol Levels With the Psychological Performance in Primary Hyperparathyroidism Patients

Abstract

ObjectivesThe aim of this study was to investigate factors responsible for the psychological performance in primary hyperparathyroidism (PHPT) patients.MethodsA group of 38 PHPT patients receiving questionnaires, including Beck Depression Inventory (BDI), State–Trait Anxiety Inventory (STAI), and 36-Item Short Form Survey (SF-36), was evaluated. The relationships between scores of questionnaires and clinical biomarkers were examined. Collinearity and linear regression model were applied to examine variables determining the scores of the questionnaire. In 192 PHPT patients, bivariate and partial correlation were used to analyze the relationships between serum concentrations of parathyroid hormone (PTH), calcium, osteocalcin (OCN), and cortisol.ResultsAmong 38 patients receiving questionnaire tests, 50% (19/38) of the patients developed state anxiety, 60.5% (23/38) of the patients had the trait of developing anxiety. In addition, 18.4% (7/38) of the patients developed mild to severe depression. Serum cortisol at 8:00 was negatively and significantly correlated with social function (r = -0.389, p = 0.041) after controlling for age, sex, disease duration, serum PTH, calcium, phosphorus, and 25-hydroxyvitamin D [25(OH)D] concentration. OCN was significantly and negatively correlated with score of STAI-S (r = -0.426, p = 0.027). In the linear regression model for BDI score, variables with statistical significance were serum OCN (β = -0.422, p = 0.019) and cortisol at 0:00 (β = 0.371, p = 0.037). In 192 PHPT patients, the serum concentration of OCN (r = 0.373, p = 0.000) was positively correlated with PTH level. After controlling for age, sex, disease duration, serum 25(OH)D, phosphorus, and calcium concentration, the positive correlation between OCN and PTH was still statistically significant (r = 0.323, p = 0.000). The serum concentration of cortisol at 0:00 was significantly and positively correlated with serum calcium (r = 0.246, p = 0.001) in bivariate correlation analysis. After controlling for age, sex, disease duration, serum PTH, 25(OH)D, and phosphorus concentration, serum cortisol at 0:00 was still positively and significantly correlated with serum calcium (r = 0.245, p = 0.001).ConclusionSerum levels of OCN and cortisol, rather than PTH and calcium, are associated with the development of anxiety and depression symptoms in PHPT patients.

Association of Major Depressive Disorder in Hyperparathyroidism: A Systematic Review

“…A study conducted by Wang and co-authors in the year 2021 showcased 38 patients with hyperparathyroidism who received a psychologic evaluation, through Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and 36-item Short Form Survey (SF-36) questionnaires out of which 32.2% of patients experienced anxiety, 31.8% were on the trait of anxiety, 18.4% of patients experienced mild to severe depression and 15.9% of patients had anxiety and depression both [2]. Serum calcium concentration (p = 0.006) was increased in patients with depression and anxiety.…”

“…Parathyroid glands secrete parathyroid hormone (PTH), which is mainly regulated by calcium metabolism. Elevated serum calcium (Ca 2+ ) levels decrease the release of PTH and vice versa [2]. Primary hyperparathyroidism (PHPT) is a disorder of PTH hypersecretion by parathyroid glands in patients with normal renal function, resulting in increased serum calcium concentration.…”

Association of Famine Exposure on the Changing Clinical Phenotypes of Primary Hyperparathyroidism in 20 years

“…The classical symptoms of PHPT involve bone, kidney, gastrointestinal manifestations, such as bone pain, fracture, osteoporosis, urolithiasis, nausea, vomiting, and etc. There are also some nonclassical features, including neuropsychiatric, cardiovascular and metabolic abnormities (3).…”