Abstract
BACKGROUND: Patients with glaucoma demonstrate significantly elevated prevalence rates of anxiety and depression compared to healthy controls, although these psychiatric comorbidities remain frequently underrecognised in clinical practice. This study evaluated serum neuropeptide Y (NPY) concentrations in patients with primary glaucoma to investigate potential associations with anxiety, depression, and quality of life (QOL). METHODS: The study cohort comprised 45 healthy controls and 89 patients with primary glaucoma, including 55 patients with primary open-angle glaucoma (POAG) and 34 patients with primary angle-closure glaucoma (PACG). Peripheral blood samples were collected, and anxiety, depression, and QOL scores were recorded. Serum NPY levels were measured using an enzyme-linked immunosorbent assay. Univariate analyses and multivariate logistic regression analyses were employed. RESULTS: Serum NPY concentrations were significantly lower in primary glaucoma patients than in healthy individuals (P < 0.001). Among glaucoma patients, those with comorbid anxiety or depressive disorders presented markedly lower NPY levels than patients without anxiety and depression (P < 0.001). Multivariate analysis revealed that in the glaucoma cohort, anxiety was significantly associated with serum NPY levels, economic burden, and increased intraocular pressure in both eyes, whereas depression was significantly associated with serum NPY levels and economic burden. The QOL scores revealed that serum NPY levels were positively correlated with bodily pain and role-physical in primary glaucoma patients with comorbid anxiety. Similarly, NPY levels were positively correlated with mental health in primary glaucoma patients with depression. Furthermore, serum NPY levels in primary glaucoma patients were associated with MD values in the worse eye. CONCLUSION: Serum NPY concentrations were identified as an independent predictor of both anxiety and depression in patients with primary glaucoma. Moreover, lower serum NPY levels were significantly inversely associated with glaucoma severity.