OBJECTIVE: The renin-angiotensin-aldosterone-system (RAAS) has gained increasing attention in the investigation of the pathogenesis of depression. Primary hyperaldosteronism (PA) is associated with a marked aldosterone excess. Prior studies on PA describe an increased prevalence of anxiety and sub-threshold depressive symptoms in these patients. METHODS: In a cross-sectional exploratory study we investigated 132 patients with PA. Twenty-seven patients were studied before initiation of specific treatment (U = untreated), 56 were studied 5.4 years after initiation of mineralocorticoid antagonist treatment (MRA) and 49 patients were studied 4.3 years after unilateral adrenalectomy (ADX). GAD-7 and PHQD self-rating questionnaires were used to assess symptoms for anxiety and depression. RESULTS: No significant difference was found between the three investigated groups. A higher prevalence for depression and anxiety compared to the normal population was found. Women of all groups had higher mean values compared to men, for depression in untreated patients this difference was found to be significant. Correlations between the psychopathology and hormones were only found for renin. Plasma renin concentration correlated significantly with anxious symptoms of untreated females. CONCLUSIONS: This study supports the RAAS to be involved in the pathogenesis of depression as patients with PA seem to be more depressive and anxious compared to the normal population. Gender differences in the regulation of the RAAS seem to be apparent, as females were more affected by the dysregulation than males.
OBJECTIVE: The renin-angiotensin-aldosterone-system (RAAS) has gained increasing attention in the investigation of the pathogenesis of depression. Primary hyperaldosteronism (PA) is associated with a marked aldosterone excess. Prior studies on PA describe an increased prevalence of anxiety and sub-threshold depressive symptoms in these patients. METHODS: In a cross-sectional exploratory study we investigated 132 patients with PA. Twenty-seven patients were studied before initiation of specific treatment (U = untreated), 56 were studied 5.4 years after initiation of mineralocorticoid antagonist treatment (MRA) and 49 patients were studied 4.3 years after unilateral adrenalectomy (ADX). GAD-7 and PHQD self-rating questionnaires were used to assess symptoms for anxiety and depression. RESULTS: No significant difference was found between the three investigated groups. A higher prevalence for depression and anxiety compared to the normal population was found. Women of all groups had higher mean values compared to men, for depression in untreated patients this difference was found to be significant. Correlations between the psychopathology and hormones were only found for renin. Plasma renin concentration correlated significantly with anxious symptoms of untreated females. CONCLUSIONS: This study supports the RAAS to be involved in the pathogenesis of depression as patients with PA seem to be more depressive and anxious compared to the normal population. Gender differences in the regulation of the RAAS seem to be apparent, as females were more affected by the dysregulation than males.
Authors: Wiebke Arlt; Katharina Lang; Alice J Sitch; Anna S Dietz; Yara Rhayem; Irina Bancos; Annette Feuchtinger; Vasileios Chortis; Lorna C Gilligan; Philippe Ludwig; Anna Riester; Evelyn Asbach; Beverly A Hughes; Donna M O'Neil; Martin Bidlingmaier; Jeremy W Tomlinson; Zaki K Hassan-Smith; D Aled Rees; Christian Adolf; Stefanie Hahner; Marcus Quinkler; Tanja Dekkers; Jaap Deinum; Michael Biehl; Brian G Keevil; Cedric Hl Shackleton; Jonathan J Deeks; Axel K Walch; Felix Beuschlein; Martin Reincke Journal: JCI Insight Date: 2017-04-20
Authors: Marieke Stientje Velema; Aline de Nooijer; Ad R M M Hermus; Henri J L M Timmers; Jacques W M Lenders; Olga Husson; Jaap Deinum Journal: Endocr Connect Date: 2019-04 Impact factor: 3.335
Authors: Lukas Engler; Christian Adolf; Daniel A Heinrich; Anna-Katharine Brem; Anna Riester; Anna Franke; Felix Beuschlein; Martin Reincke; Axel Steiger; Heike Künzel Journal: Endocr Connect Date: 2019-04 Impact factor: 3.335
Authors: Karl-Heinz Storbeck; Lina Schiffer; Elizabeth S Baranowski; Vasileios Chortis; Alessandro Prete; Lise Barnard; Lorna C Gilligan; Angela E Taylor; Jan Idkowiak; Wiebke Arlt; Cedric H L Shackleton Journal: Endocr Rev Date: 2019-12-01 Impact factor: 19.871