Osteocalcin, Cortisol Associated With Depression and Anxiety in Patients with Primary Hyperparathyroidism

Serum levels of osteocalcin (OCN) and cortisol are associated with depression and anxiety in patients with primary hyperparathyroidism (PHPT), according to recent research published in Frontiers in Endocrinology.

“Several studies suggested that PHPT was associated with impaired quality of life (QoL), anxiety, and depression as evaluated by questionnaires. Although these symptoms are concerning, there is a debate upon whether these symptoms are directly and specifically attributable to PHPT,” wrote Shu-min Wang, Doctoral Student, Shanghai Jiao Tong University, Shanghai, China, and co-researchers.  

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The study aimed to determine the cause of psychological symptoms in patients with PHPT.

A total of 38 patients with PHPT answered the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and the 36-Item Short Form Survey (SF-36). Researchers analyzed the bivariate and partial correlation of 192 patients with PHPT to compare the relationship of serums concentrations of parathyroid hormone (PHT), calcium, OCN, and cortisol.

Nineteen patients recorded developing state anxiety, 23 patients reported developing anxiety, and 7 patients developed mild to severe depression.

STAI scores showed a negative correlation with OCN. Serum cortisol was negatively correlated with social function after controlling for serum PTH, calcium, phosphorus, 25-hydroxycitamin D concentration, disease duration, age, and sex.

The serum concentration of OCN observed in the group of 192 patients was associated with PTH level. There was a statistically significant correction between OCN and PTH after controlling for calcium concentration, disease duration, age, sex, serum 25(OH)D, and phosphorus.

In bivariate correlation analysis, serum concentration of cortisol was positively associated with serum calcium. Serum cortisol was still significantly associated with serum calcium following controlling for age, sex, disease duration, and serum PTH, 25(OH)D, and phosphorus concentration.

“To sum up, in this study, it was demonstrated that the serum levels of OCN and cortisol were independently associated with the development of psychological symptoms in PHPT patients. More basic and clinical studies are needed to test and verify this observation,” Wang et al concluded.

Reference

Wang SM, He Y, Zhu MT, et al. The associations of serum osteocalcin and cortisol levels with the psychological performance in primary hyperparathyroidism patients. Front Endocrinol (Lausanne). 2021;12:692722.