Abstract
BackgroundDyspeptic syndrome is particularly common in postmenopausal women in the form of epigastric pain. The aim of the study was to assess the role of melatonin in chronic dyspepsia in this group of women, and examine the role of Helicobacter infection.MethodsThe study comprised 152 subjects including 30 healthy women (Group I), 60 women with asymptomatic H.pylori infection (Group II), and 64 women with H. pylori infection with chronic dyspepsia (Group III). Endoscopic examination was performed, as well as histological assessment of gastric end duodenal mucosa, urease breath test (UBT-13C), and immunoenzymatic assessment of serum 17-β-estradiol, follicle stimulating hormone and melatonin, and urinary 6-sulfatoxymelatonin. In Group III, 14-day antibacterial treatment was introduced with pantoprazole, amoxicillin and levofloxacin followed a six-month treatment with placebo in 32 women (Group IIIa), and melatonin 1 mg/morning and 3 mg/at bedtime in the other 32 women (Group IIIb).ResultsNo significant differences were found between serum level of female hormone. Serum melatonin levels were similar between Group I (12.5 ± 2.72 pg/ml) and Group II (10.5 ± 3.73 pg/ml; p > 0,05). The level was significantly lower in Group III (5.72 ± 1.42 pg/ml; p < 0.001). Eradication of H.pylori was obtained in 75.0% women in Group IIIa, and in 84.3% in Group IIIb (p > 0.05). After six months, dyspeptic symptoms resolved in 43.7% patients in Group IIIa and 84.3% in Group IIIb (p < 0.001).ConclusionMelatonin supplementation is useful in treating H. pylori-associated dyspepsia, particularly in postmenopausal women with lower levels of this hormone.Trial registrationNCT04352062, date of registration: 15.04.2020.
Highlights
Dyspeptic syndrome is common in postmenopausal women in the form of epigastric pain
The aim of the present study was to assess the role of melatonin in the pathogenesis of chronic dyspepsia in postmenopausal women, and to examine the effect of Helicobacter pylori infection
Some researchers believe that the reduction in melatonin secretion in women begins around the age of 40 years and may initiate menopause [25]
Summary
Dyspeptic syndrome is common in postmenopausal women in the form of epigastric pain. Experimental studies have shown that like estrogens, melatonin has an inhibitory effect on the secretion of hydrochloric acid [11] and stimulates the secretion of bicarbonates in the upper gastrointestinal tract [12]. It demonstrates antioxidant [13], cytoprotective [14], myorelaxant [15] and analgesic [16] properties. Simultaneous estrogen and melatonin deficiency may create adverse conditions in the stomach and trigger dyspeptic discomfort This assumption is supported by the results of earlier studies, which found reduced melatonin secretion in patients with functional dyspepsia [17]. The expression of melatonin-synthesizing enzymes in the gastric mucosa [18, 19] and the concentration of melatonin in gastric juice [20] may be reduced
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