Vitamin D status is associated with anxiety levels in postmenopausal women evaluated for osteoporosis

Gabriella Martino, Antonino Catalano, Federica Bellone, Alberto Sardella, Carmen Lasco, Tindara Caprì, Viviana Langher, Andrea Caputo, Rosa Angela Fabio, Nunziata Morabito

Abstract


Vitamin D status has been previously associated with a wide range of acute and chronic diseases. The nervous system express vitamin D receptors and thus vitamin D may be involved in mental health. Poor data exist about the correlation between vitamin D and anxiety levels.Our aim was to investigate the association of vitamin D status with anxiety severity. A group of 177 postmenopausal women (mean age 65.5±8.22 yr.) referring to an outpatients clinic for the prevention of osteoporosis were evaluated. Severity of perceived anxiety symptoms was measured by the Hamilton Anxiety rating scale (HAMA). Depression levels were also evaluated using the Beck Depression Inventory-second edition scale (BDI-II).  25(OH)D serum levels, indicative of vitamin D status, were detected by high-performance liquid chromatography. 25(OH)D levels were significantly related HAMA-score (r=-0.15, p=0.04); particularly a deep association was observed between 25(OH)D levels and somatic symptoms (r=-0.195, p=0.009). HAMA score was associated with BDI-II score (r=0.487, p=<0.001); HAMA psychic symptom score was also related with age and time since menopause (r=0.149, p=0.039 and r=0.222, p=0.003, respectively). At a multiple regression analysis, after correcting for age and depression levels, 25(OH)D was predictive of HAMA score (β =-0,05961, p= 0.02, SE=-2.206), but the strength of association was lost further correcting for time since menopause.  In conclusion, in a setting of postmenopausal women, we observed a significant association between anxiety levels and serum 25(OH)D concentrations irrespective of age and depression levels.


Keywords


Vitamin D; Anxiety; Depression; Postmenopausal women; Osteoporosis

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References


1. Catalano, A., Morabito, N., Di Stefano, A., Morini, E., Basile, G., Faraci, B., Loddo, S., Ientile, R., Lasco, A. (2015).Vitamin D and bone mineral density changes in postmenopausal women treated with strontium ranelate. J Endocrinol Invest; 38(8):859-63.

2. Holick, MF. (2007). Vitamin D deficiency. N Engl J Med;357:266-281.

3. Timpini, A., Pini, L., Tantucci, C., Cossi, S., Grassi, V. (2011). Vitamin D and health status in elderly. Intern Emerg Med;6(1):11-21.

4. Atteritano, M., Mirarchi, L., Venanzi-Rullo, E., Santoro, D., Iaria, C., Catalano, A., Lasco, A., Arcoraci, V., Lo Gullo, A., Bitto, A., Squadrito, F., Cascio, A. (2018). Vitamin D Status and the Relationship with Bone Fragility Fractures in HIV-Infected Patients: A Case Control Study. Int J Mol Sci;19(1).

5. Atteritano, M., Santoro, D., Corallo, G., Visalli, E., Buemi, M., Catalano, A., Lasco, A., Bitto, A., Squadrito, F. (2016). Skin Involvement and Pulmonary Hypertension Are Associated with Vitamin D Insufficiency in Scleroderma. Int J Mol Sci.Dec 14;17(12). pii: E2103.

6. Catalano, A., Morabito, N., Basile, G., Cucinotta, D., Lasco, A. (2015). Calcifediol improve lipid profile in osteopenic atorvastatin-treated postmenopausal women. Eur J Clin Invest;45(2):144-149.

7. Oteri, G., Cicciù, M., Peditto, M., Catalano, A., Loddo, S., Pisano, M., Lasco, A. (2016). Does Vitamin D3 Have an Impact on Clinical and Biochemical Parameters Related to Third Molar Surgery. J Craniofac Surg;27(2):469-476.

8. Charara, R., Forouzanfar, M., Naghavi, M., Moradi-Lakeh, M. (2017). et al. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013. PLoS One;12(1):e0169575.

9. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545-1602.

10. Baxter, A.J., Scott, K.M., Vos, T., Whiteford, H.A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med 43(5):897-910.

11. Hong-Jhe, C., Chin-Yuan, K., Ming-Shium, T., Fu-Wei, W., Ru-Yih, C., Kuang-Chieh, H., Hsiang-Ju, P., Ming-Yueh, C., Pan-Ming, C., Chih-Chuan, P. (2016). The incidence and risk of osteoporosis in patients with anxiety disorder: A Population-based retrospective cohort study. Medicine (Baltimore);95(38):e4912.

12. Bellone, F., Catalano, A., Martino, G., Lasco, C., Pugliese, A., Morabito, N. (2017). Psychological factors may impact on postmenopausal women fracture risk. APMB.105(2) DOI: 10.6092/1828-6550/APMB.105.2.2017.OS1.

13. de Beurs, E., Beekman, A.T., van Balkom, A.J., Deeg, D.J., van Dyck, R., van Tilburg, W. (1999). Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychol Med;29(3):583-593.

14. Bierman, E.J., Comijs, H.C., Rijmen, F., Jonker, C., Beekman, A.T. (2008). Anxiety symptoms and cognitive performance in later life: results from the longitudinal aging study Amsterdam. Aging Ment Health;12(4):517-523.

15. Mehta, K.M., Simonsick, E.M., Penninx, B.W., Schulz, R., Rubin, S.M., Satterfield, S., Yaffe, K. (2003). Prevalence and correlates of anxiety symptoms in well-functioning older adults: findings from the health aging and body composition study. J Am Geriatr Soc;51(4):499-504.

16. Nguyen, T.T.T., Tsujiguchi, H., Kambayashi, Y. et al. (2017). Relationship between Vitamin Intake and Depressive Symptoms in Elderly Japanese Individuals: Differences with Gender and Body Mass Index. Nutrients;9(12).

17. Atteritano, M., Lasco, A., Mazzaferro, S., Macrì, I., Catalano, A., Santangelo, A., Bagnato, G., Bagnato, G., Frisina, N. (2013). bone mineral density, quantitative ultrasound parameters and bone metabolism in postmenopausal women with depression. Intern Emerg Med;8(6):485-491.

18. Ju, S.Y., Lee. Y.J., Jeong, S.N. (2013). Serum 25-hydroxyvitamin D levels and the risk of depression: a systematic review and meta-analysis. J Nutr Health Aging;17(5):447-455.

19. de Koning, E.J., Verweij, L., Lips, P., Beekman, A.T.F., Comijs, H.C., van Schoor, N.M. (2017). The relationship between serum 25(OH)D levels and anxiety symptoms in older persons: Results from the Longitudinal Aging Study Amsterdam. J Psychosom Res;97:90-95.

20. Armstrong, D.J., Meenagh, G.K., Bickle, I., Lee, A.S., Curran, E.S., Finch, M.B. (2007). Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol;26(4):551-554.

21. Callegari, E.T., Reavley, N., Gorelik, A., Garland, S.M., Wark, J.D. (2017). Safe-D study team. Serum 25-hydroxyvitamin D and mental health in young Australian women: Results from the Safe-D study. J Affect Disord;224:48-55.

22. Catalano, A., Morabito, N., Basile, G., Fusco, S., Castagna, G., Reitano, F., Albanese, R.C., Lasco, A. (2013). Fracture risk assessment in postmenopausal women referred to an Italian center for osteoporosis: a single day experience in Messina. Clin Cases Miner Bone Metab;10(3):191-194.

23. Di Rosa, A.E., Epifanio, A., Antonini, A., Stocchi, F., Martino, G., Di Blasi, L., Tetto, A., Basile, G., Imbesi, D., La Spina, P., Di Raimondo, G., Morgante, L. (2003). Continuous apomorphine infusion and neuropsychiatric disorders: a controlled study in patients with advanced Parkinson's disease. Neurol Sci;24(3):174-175.

24. Merendino, R.A., Di Pasquale, G., De Luca, F., Di Pasquale, L., Ferlazzo, E., Martino, G., Palumbo, M.C., Morabito, F., Gangemi, S. (2004). Involvement of fractalkine and macrophage inflammatory protein-1 alpha in moderate-severe depression. Mediators Inflamm;13(3):205-207.

25. De Domenico, P., Di Rosa, A.E., D’Agostino, A.A., Martino, G., Meduri, M., Spina, E. (1999). The effect of clozapine on aggressive behaviour in patients with chronic schizophrenia.Int J Psychiatry Clin Pract;3(1):49-54.

26. Martino, G., Caprì, T., Castriciano, C., Fabio, R.A. (2017). Automatic Deficits can lead to executive deficits in ADHD. Mediterranean Journal of Clinical Psychology;5:3 DOI: http://dx.doi.org/10.6092/2282-1619/2017.5.1669

27. D'Aguanno, M., Langher, V., Velotti, P. (2017). Emotion dysregulation in alcohol related intimate partner violence: a systematic review. Mediterranean Journal of Clinical Psychology; 5:1 doi:10.6092/2282-1619/2017.5.1380

28. Caputo, A., Giacchetta, A., Langher, V. (2016). AIDS as social construction: text mining of AIDS-related information in the Italian press. AIDS Care;28(9):1171-1176.

29. Ross, A.C., Manson, J.E., Abrams, S.A., Aloia, J.F., Brannon, P.M., Clinton, S.K., Durazo-Arvizu, R.A., Gallagher, J.C., Gallo, R.L., Jones, G., Kovacs, C.S., Mayne, S.T., Rosen, C.J., Shapses, S.A. (2011). The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab;96:53-58.

30. Hamilton, M. (1959). The assessment of anxiety states by rating. Br J Med Psychol;32:50-55.

31. Beck, A.T., Steer, R.A., Brown, G.K. (1996). Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corporation.

32. Langher, V., Caputo, A., Martino, G. (2017). What happened to the clinical approach to case study in psychological research? A clinical psychological analysis of scientific articles in high impact-factor journals. Mediterranean Journal of Clinical Psychology;5:3 DOI: 10.6092/2282-1619/2017.5.1670

33. Buell, J.S., Dawson-Hughes, B. (2008). Vitamin D and neurocognitive dysfunction: preventing "D"ecline? Mol Aspects Med;29(6):415-422.

34. Wrzosek, M., Łukaszkiewicz, J., Wrzosek, M., Jakubczyk, A., Matsumoto, H., Piątkiewicz, P., Radziwoń-Zaleska, M., Wojnar, M., Nowicka, G. (2013).Vitamin D and the central nervous system. Pharmacol Rep;65(2):271-278.

35. Kalueff, A.V., Lou, Y.R., Laaksi, I., Tuohimaa, P. (2004). Increased anxiety in mice lacking vitamin D receptor gene. Neuroreport;15(8):1271-1274.

36. Fedotova, J., Pivina, S., Sushko, A. (2017). Effects of Chronic Vitamin D₃ Hormone Administration on Anxiety-Like Behavior in Adult Female Rats after Long-Term Ovariectomy. Nutrients;9(1). pii: E28. doi: 10.3390/nu9010028.

37. Valipour, G., Saneei, P., Esmaillzadeh, A. (2014). Serum vitamin D levels in relation to schizophrenia: a systematic review and meta-analysis of observational studies. J Clin Endocrinol Metab;99(10):3863-3872.

38. Catalano, A., Martino, G., Morabito, N., Scarcella, C., Gaudio, A., Basile, G., Lasco, A. (2017). Pain in osteoporosis: from pathophysiology to therapeutic approach. Drugs Aging; 34:755-765.

39. Catalano, A., Morabito, N., Atteritano, M., Basile, G., Cucinotta, D., Lasco, A. (2012). Vitamin D reduces musculoskeletal pain after infusion of zoledronic acid for postmenopausal osteoporosis. Calcif Tissue Int;90(4):279-285.

40. Lasco, A., Catalano, A., Benvenga, S. (2012). Improvement of primary dysmenorrhea caused by a single oral dose of vitamin D: results of a randomized, double-blind, placebo-controlled study. Arch Intern Med;172(4):366-367.




DOI: http://dx.doi.org/10.6092/2282-1619/2018.6.1740

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