Correlation analysis of sex hormone levels with depression and anxiety in Parkinson's disease

Abstract

Objective To investigate the correlation of sex hormone levels with depression and anxiety in Parkinson's disease (PD).  Methods A total of 46 PD patients (27 male and 19 female) were enrolled in this study. After withdrawing anti-PD drugs for 12 h, their fasting blood was taken from cubital vein. Electrochemiluminescence (ECL) assay was used to detect serum estradiol, progesterone and testosterone. Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) were used to evaluate depression and anxiety.  Results Fourteen cases (30.43%) were diagnosed as possible depression (HAMD score 8-19), and 5 cases (10.87% ) were diagnosed as definite depression (HAMD score ≥ 20). Nine cases (19.57%) were diagnosed as possible anxiety (HAMA score 7-13), and 7 cases (15.22%) were diagnosed as definite anxiety (HAMA score ≥ 14). The body mass index (BMI) of female PD patients was significantly higher than that of male [(26.93 ± 1.29) kg/m² vs. (23.99 ± 1.51) kg/m²; t = 6.872, P = 0.000]. The serum estradiol [(46.29 ± 17.87) pmol/L vs. (129.64 ± 32.34) pmol/L; t = 10.080, P = 0.000], progesterone [0.99 (0.67, 1.18) nmol/L vs. 1.30 (0.86, 2.04) nmol/L; Z = -2.722, P = 0.006] and testosterone [(0.38 ± 0.17) nmol/L vs. (13.52 ± 5.41) nmol/L; t = 10.538, P = 0.000] in female PD patients were significantly lower than those in male patients. In female PD patients, BMI was negatively correlated with HAMA score (r = -0.591, P = 0.020), serum estradiol level was negatively correlated with HAMD score (r = -0.558, P = 0.031) and HAMA score (r = -0.675, P = 0.006), serum testosterone level was positively correlated with HAMA score (r = 0.674, P = 0.006). In male PD patients, only serum testosterone level was negatively correlated with HAMD score (r = -0.450, P = 0.031) and HAMA score (r = -0.507, P = 0.013).  Conclusions Non-motor symptoms, such as depression and anxiety, are very common in PD. The lower serum estradiol level, the more severe depression was in female PD patients. The lower BMI and serum estradiol level and the higher serum testosterone level, the more severe anxiety was in female PD patients. The lower serum testosterone level, the more severe depression and anxiety were in male PD patients. Therefore, hormone replacement therapy may become a new method for improving depression and anxiety symptoms in PD.

DOI: 10.3969/j.issn.1672-6731.2018.04.007