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.

Key words: Parkinson disease, Gonadal steroid hormones, Depression, Anxiety

摘要：

目的 探讨帕金森病患者血清性激素水平与抑郁和焦虑等帕金森病非运动症状的相关性。方法 共46 例帕金森病患者（男性27 例，女性19 例）均于停用抗帕金森病药物12 h 后空腹采集肘静脉血，电化学发光法检测血清雌二醇、孕酮和睾酮水平，汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评价抑郁和焦虑症状。结果46 例患者中14 例（30.43%）诊断为可能的抑郁症（HAMD 评分8 ~ 19 分），5 例（10.87%）诊断为确定的抑郁症（HAMD 评分≥ 20 分）；9 例（19.57%）诊断为可能的焦虑症（HAMA 评分7 ~ 13 分），7 例（15.22%）诊断为确定的焦虑症（HAMA 评分≥ 14 分）。女性帕金森病患者体重指数高于男性［（26.93 ± 1.29）kg/m² 对（23.99 ± 1.51）kg/m²；t = 6.872，P = 0.000］，血清雌二醇［（46.29 ± 17.87）pmol/L 对（129.64 ± 32.34）pmol/L；t = 10.080，P = 0.000］、孕酮［0.99（0.67，1.18）nmol/L 对1.30（0.86，2.04）nmol/L；Z = -2.722，P = 0.006］和睾酮［（0.38 ± 0.17）nmol/L 对（13.52 ± 5.41）nmol/L；t =10.538，P = 0.000］均低于男性。女性帕金森病患者体重指数与HAMA 评分呈负相关（r = -0.591，P = 0.020），血清雌二醇水平与HAMD 评分（r = -0.558，P = 0.031）和HAMA 评分（r = -0.675，P = 0.006）呈负相关，血清睾酮水平与HAMA 评分呈正相关（r = 0.674，P = 0.006）；男性帕金森病患者仅血清睾酮水平与HAMD 评分（r = -0.450，P = 0.031）和HAMA 评分（r = -0.507，P = 0.013）呈负相关。结论 帕金森病患者抑郁和焦虑等非运动症状常见，女性患者血清雌二醇水平越低、抑郁症状越严重，体重指数和血清雌二醇水平越低、血清睾酮水平越高、焦虑症状越严重；男性患者血清睾酮水平越低、抑郁和焦虑症状越严重。故性激素替代治疗可能成为改善帕金森病患者抑郁和焦虑症状的方法之一。

关键词: 帕金森病, 性腺甾类激素, 抑郁, 焦虑