title: Relationship between parathyroid hormone and depression in heart failure.
abstract: BACKGROUND
  Depression has been found to be a predictor of rehospitalization and mortality in heart failure (HF). Parathyroid hormone (PTH) is a novel promising biomarker that can predict hospitalization, functional status and mortality in HF.
  
  
  OBJECTIVE
  We aimed to investigate the association of depression with serum PTH levels in patients with systolic HF.
  
  
  METHODS
  A total of consecutive 100 outpatients with systolic HF having left ventricular ejection fraction (LVEF) < 40%, were prospectively studied. All patients underwent laboratory tests, including brain natriuretic peptide (BNP) and PTH analyses. The patients were asked to complete the Beck Depression Inventory- II (BDI).
  
  
  RESULTS
  Fifty-one patients (51%) were shown to have poor BDI score (BDIS > 18). Patients with poor BDI score had significantly higher PTH levels compared to those with good BDIS (133 ± 46 pg/ml vs. 71 ± 26 pg/ml, p < 0.001). In multivariable logistic regression model, PTH level (Odds ratio (OR) = 1.035, p = 0.003), LVEF (OR = 0.854, p = 0.004), NYHA functional class III/IV (OR = 28.022, p = 0.005), C-reactive protein (CRP) (OR = 1.088, p = 0.020), and presence of pretibial edema (OR = 12.341, p = 0.033) were found to be independent predictors of moderate to severe depression after adjustment of other potential confounders.
  
  
  CONCLUSIONS
  Systolic HF patients with moderate to severe depression had higher serum levels of PTH and CRP, poor functional status and lower LVEF. The association of depression with such parameters might explain the contribution of depression to hospitalization and mortality in HF.
authors.affiliation: Department of Cardiology, Baskent University Faculty of Medicine, Adana, Turkey. sakaltay@yahoo.com
authors.forename: Hakan
authors.initials: H
authors.lastname: Altay
authors.forename: Ali
authors.initials: A
authors.lastname: Zorlu
authors.forename: Halil Tolga
authors.initials: HT
authors.lastname: Kocum
authors.forename: Senol
authors.initials: S
authors.lastname: Demircan
authors.forename: Nuryil
authors.initials: N
authors.lastname: Yilmaz
authors.forename: Mehmet Birhan
authors.initials: MB
authors.lastname: Yilmaz
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003863:Depression / Q000097:blood* / Q000503:physiopathology; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D002097:C-Reactive Protein