Melatonin Levels In Patients Research Articles

Melatonin levels and embryo quality in IVF patients with diminished ovarian reserve: a comparative study

BackgroundMelatonin, a hormone found in various bodily fluids and cells, is known for its potent antioxidative, anti-apoptotic, and endocrine regulatory properties. This study aimed to analyze melatonin levels in patients with diminished ovarian reserve (DOR) and its impact on embryo quality.MethodsWe enrolled 85 women who were undergoing in vitro fertilization or intracytoplasmic sperm injection procedures, including normal ovarian reserve (NOR, n = 27), pathological DOR (DOR-Path, n = 25), and physiological DOR (DOR-Phy, n = 33). Melatonin levels in patient serum and follicular fluid were assessed using ELISA, and correlations between melatonin levels and indicators of embryo quality were examined.ResultsOur findings indicate that melatonin levels in the follicular fluid and basal serum of the DOR-Path and DOR-Phy groups were lower compared to the NOR group (P < 0.05). However, no significant differences in melatonin levels were found between the DOR-Path and DOR-Phy groups (P > 0.05). Additionally, the concentration of melatonin in the follicular fluid of the NOR group was significantly higher than in their serum (P < 0.001). Lastly, a significant correlation was discovered between melatonin levels in serum and follicular fluid and parameters of ovarian reserve and embryonic development (P < 0.05).ConclusionsMelatonin levels in DOR patients may impact embryo quality, offering insights into potential DOR pathogenesis and opportunities to enhance treatment outcomes in these patients.

Serum melatonin levels and in a sample of Iranian patients with migraine

Migraine, a complex disorder, is characterized by recurrent headache episodes. The production of melatonin in the pineal gland, which is crucial for controlling circadian rhythms and sleep–wake cycles, is altered in various conditions, including neurological disorders such as migraine. Recent studies underscore the significance of serum melatonin levels in patients with chronic and episodic migraine, the focus of this study. This case‒control study, conducted from September 2017 to June 2020 in Tehran, Iran, selected potential participants aged 18–65 years from a headache clinic at Sina Hospital (affiliated with Tehran University of Medical Sciences). Both episodic migraine and chronic migraine were diagnosed following the diagnostic criteria in the International Classification of Headache Disorders’ third edition. Melatonin levels were measured according to the instructions of the ELISA kits. There were significant differences in the frequency of headache days and the duration of abortive medication usage between the two groups (P value < 0.001). Besides, analysis revealed significantly lower serum melatonin levels in patients with episodic ((80.45–45.06) 72.83) and chronic migraine ((154.34–63.34) 70.38, P value < 0.001) than in healthy controls (281.25–160.86) 280). Although no considerable differences were found between episodic and chronic migraine patients, the current study demonstrated that serum melatonin levels were substantially greater in healthy controls than in patients with migraine.

Comparative evaluation of salivary melatonin levels in patients with bruxism: a case-control study.

Aim: To examine whether there is any difference in the levels of salivary melatonin between bruxism and nonbruxism groups and to compare the stress and anxiety levels between the two groups.Materials & methods: Patients meeting the probable bruxism criteria according to the International Consensus on the Assessment of Bruxism Criteria were included in the bruxism group. The salivary melatonin concentrations of both groups were measured using an ELISA kit. To determine the relationship between stress and bruxism, the State-Trait Anxiety Inventory (STAI) test was used.Results: The bruxism group had a significantly lower night-time salivary melatonin level than the control group (p<0.05). No significant difference was determined between the bruxism group and the control group in respect of the STAI-T scores (p>0.05).Conclusion: The study findings revealed a strong relationship between a low melatonin level and bruxism.

Melatonin and sexual development of adolescents with type 1 diabetes

Objective — to study the level of daily melatonin excretion in adolescents with type 1 diabetes mellitus (DM1) at the stages of puberty, taking into account the course of puberty. Materials and methods. The investigation involved 172 patients with DM1 aged 9—18 years (85 boys and 87 girls), who stayed in the Endocrinology Department of the SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine» for examinations and treatment. The DM1 duration was 1 to 10 years. With account of the level of sexual development at the time of examination, adolescents were divided into the following subgroups: prepuberty (T1); early puberty (T2); puberty itself (T3); late puberty (T4). The nature of sexual maturation was assessed with account of the norms for the corresponding age. The nature of melatonin production was assessed by the excretion of its main metabolite — 6-­sulfatoxymelatonin in daily urine, which was determined by fluorometric method. Statistical processing of the results was carried out using application packages Microsoft Excel and SPSS 17.0. Results and discussion. The effects of puberty on melatonin production have been determined, with its increase during puberty and late puberty. It has been proven that violation of the puberty course is accompanied with changes in the melatonin levels, corresponding to the degree of sexual development of girls and boys with DM1. In conditions of accelerated puberty, the melatonin level increases, and it decreases in case of slowdown sexual development. In girls of 14—18 years old, the lowest melatonin levels were determined in patients with delayed sexual development and primary amenorrhea. During sexual maturation, formation of epiphyseal­pituitary­gonadal and epiphyseal­pituitary­thyroid links takes place, their nature changes in the course puberty. Conclusions. In adolescents with DM1, the age-related dynamics of daily melatonin excretion during puberty is preserved, with an increase in its levels during late puberty. Melatonin levels in patients with DM1 depend on the sexual maturation course, and they are altered in case of its disorders. Regardless of gender, at delayed sexual development significantly lower melatonin levels were registered in comparison with patients with normal sexual development. The nature of correlations between melatonin and hormonal indicators depends on the level of an adolescent’s sexual development and gender.

Melatonin exchange in infertile women with repeated implantation failures

Background. Repeated implantation failure occurs in approximately 10–15% of women undergoing in vitro fertilization and embryo transfer (IVF-ET) cycles. One of the important factors is the changed morpho-functional state of the endometrium and chronodestruction in the woman’s body. Objective of the study: to determine the characteristics of melatonin (MT) metabolism in infertile women with repeated implantation failures in IVF-ET cycles. Material and methods. 103 women of reproductive age with infertility and repeated implantation failures who were treated in IVF-ET cycles were observed. Depending on the onset of pregnancy in the current IVF-ET cycle, women were divided into 2 groups: group A – 35 women with the onset of pregnancy, group B – 68 patients without the onset of pregnancy. The control group (group C) included 32 healthy fertile women. The MT level in blood serum and 6-sulfatoxymelatonin (aMT6s) in urine was determined. Results. The initial levels of MT in patients of group A (11.38 ± 0.38 pg/ml) and in group B (9.55 ± 0.27 pg/ml) were lower than in group C (13.67 ± 0.65 pg/ml) in 1.20 (p &lt; 0.01) and 1.43 (p &lt; 0.01) times, respectively. At the same time, the level of MT in women of group A was 1.19 times higher than in the group B (p &lt; 0.03). Excretion of aMT6s in urine in group A (5.09 ± 0.19 ng/ml Cr) and in group B (3.03 ± 0.09 ng/ml Cr) were lower than in group C (6.12 ± 0.21 ng/ml Cr) respectively in 1.20 (p &lt; 0.01) and 2.02 (p &lt; 0.01) times. The aMT6s concentration in urine in patients of group A was 1.68 times higher than in group B (p &lt; 0.01). A direct relationship was established between the levels of serum MT and urinary aMT6s, which was most adequately approximated by a polynomial dependence: y = 0.0139x2 – 0.1127x + 3.2978, R² = 0.2994, r = 0.51, p &lt; 0.01. Conclusions. Women with repeated implantation failures are characterized by a decrease in the level of MT in blood serum and its main metabolite aMT6s in urine, which may be one of the key factors of implantation failure.

Seasonal changes in melatonin in peptic ulcer disease

Melatonin is the main neuroendocrine hormone of the pineal gland. A distinctive feature of melatonin indole is its ability to regulate physiological processes related to the circadian rhythm. Numerous scientific data demonstrate the importance of melatonin in the development of organic and functional pathologies of the gastrointestinal tract (GIT), due to the close relationship between the hormone and intestinal structures. The paper presents the results of our study and shows dynamic variations in seasonal gradations of melatonin levels in patients with gastric and duodenal ulcers. The studies have shown that in patients with gastric and duodenal ulcers, the level of the hormone melatonin varied depending on the season. During the period of long daylight hours (spring and summer), the content of indole in the blood was ≥1 pg/ml, while during the period of minimal daylight (autumn and winter), the content of melatonin was ≤1 pg/ml. Therefore, if the melatonin level is less than 1 pg/ ml in spring and summer, and more than 1 pg/ml in autumn and winter, it can be concluded that an individual does not have peptic ulcer disease. Thus, the melatonin shift in the blood at different time limits relative to light illumination can be used as a laboratory biomarker of desynchronosis associated with the risk of developing acid-related diseases, in particular seasonal exacerbation of gastric and duodenal ulcers. Accordingly, revealing the causes and mechanism of development of seasonal exacerbation of peptic ulcer disease can help in early prediction and prevention of this nosology.

Neuroprotective Potential of Melatonin: Evaluating Therapeutic Efficacy in Alzheimer's and Parkinson's Diseases.

Decreased melatonin levels have been linked to both Alzheimer's disease (AD) and Parkinson's disease (PD), which are the two most prevalent neurodegenerative disorders. The development of sleep disorders is widespread in patients diagnosed with AD or PD. In this regard, calcification of the pineal gland, typically seen in the third decade, has been associated with a reduction in melatonin production. Recent studies have suggested that exogenous melatonin application can be utilized to treat sleep disorders in patients with neurodegenerative diseases. Furthermore, research has shown that deficiencies in melatonin levels in patients with AD or PD begin before a diagnosis of eitherdisease is made. These findings could encourage further research on melatonin as a potential biomarker for the diagnosis or a possible area for the early treatment of these diseases. Many clinical studies have also produced data denoting melatonin treatment as a method to reduce the detrimental neurocognitive effects of these diseases. Further research on the role of melatonin in neurodegenerative diseases could expand symptomatic and prophylactic treatment options for diseases such as AD and PD. This review investigates melatonin's physiological properties, its role in AD and PD, and current findings on its potential therapeutic benefits in AD and PD patients.

The evaluation of melatonin levels in chronic spontaneous urticaria: A case control study.

Although sleep disturbance is known to be common in patients with chronic spontaneous urticaria (CSU), sleep hormone levels in the blood have never before been studied in CSU. In this study, we aimed to evaluate the serum melatonin levels in patients with CSU. For the patient group, 80 patients with recently diagnosed CSU, and, for the control group, 75 healthy controls(HC) were included. The study participants' melatonin levels were measured by using the enzyme-linked immunosorbent assay method. CSU disease activity was evaluated by using the urticaria activity score-7 (UAS-7), and the quality of life was assessed with the chronic urticaria quality of life questionnaire (CU-Q2oL). The patients with concomitant diseaseslikely to affect the melatonin levels or those using related medications were excluded from the study. The patient group consisted of 53 female subjects (67%); the median (interquartile range) age was 34 years (27-43 years). The levels of melatonin were lower in the patients with CSU when compared with the HCs (p < 0.03). The melatoninlevels had no significant relationship between UAS-7 and the total scores in CU-Q2oL (p > 0.05). However, a significantnegative correlation in the melatonin levels was observed with questions 7 (overall sleep assessment) and 11 (difficulty in falling into sleep) in the CU-Q2oL (r = -0.55 [p < 0.001] and r = -0.62 [p < 0.001], respectively). The presence of low melatonin levels in the patients with CSU suggests that melatonin has a key regulatory role in the CSU development in addition to the deterioration in sleep quality. A new treatment strategy to increase the melatoninlevels in CSU may be pursued in further studies to confirm our findings.

Evaluation of the effect of direct-acting antiviral agents on melatonin level and lipid peroxidation in chronic hepatitis C patients.

Background: Oxidative stress and its end products, such as malondialdehyde (MDA) play a leading role in the pathogenesis of hepatitis C. Melatonin is a hormone that helps regulate circadian rhythms, which likely play a role in infectious diseases in terms of susceptibility, clinical expression, and outcome. Objective: The present study was conducted to assess serum malondialdehyde and melatonin levels in patients with chronic hepatitis C infection before and after the intake of direct-acting antivirals. Method: Forty hepatitis C patients were the subjects of this study. While ten healthy volunteers who matched in age and socioeconomic status served as the control subjects. Malondialdehyde and melatonin were assayed in the serum of the three groups, and the results were statistically analyzed. Results: Hepatitis C patients had significantly higher malondialdehyde (p < 0.001) but significantly lower melatonin (p < 0.001) as compared to the healthy controls. After 12weeks of treatment with direct-acting antivirals, the malondialdehyde level decreased significantly (p < 0.001) and the melatonin level increased significantly (p < 0.001). A significant negative correlation between malondialdehyde and melatonin was observed. Conclusion: The present findings suggest that treatment of hepatitis C patients with Direct-acting antivirals improves liver function parameters and antioxidant profiles.

Effect of nonsurgical periodontal therapy on salivary melatonin levels in patients with periodontal disease.

Periodontitis is an inflammatory disease in which periodontal tissues are damaged as a result of an imbalance in the oxidant/antioxidant systems. Melatonin is one hormone that controls circadian rhythms and is also an antioxidant and immune modulator. The present study was aimed to evaluate the effect of scaling and root planing (SRP) on salivary melatonin levels (SM) in patients with periodontal disease. A single-center clinical trial was conducted to evaluate the effect of SRP on SM levels in patients with periodontal disease. Forty-five participants of age 30-60 years were equally divided into three groups: 15 healthy participants, 15 participants with gingivitis, and 15 participants with periodontitis. Unstimulated salivary samples were collected from all the participants at baseline and 1 month after SRP from participants of gingivitis and periodontitis group and SM levels were determined by commercially available ELISA kit. Group comparisons were made using t-test. The level of significance was set at a P < 0.05 for all tests. SM levels were significantly lower in the chronic periodontitis group. There was a significant improvement in clinical parameters and SM levels in both chronic periodontitis and gingivitis groups after SRP. This study determined that there is a negative correlation between SM levels and the severity of periodontal disease and showed a significant increase in SM levels after SRP, suggesting that melatonin might have a protective role against periodontal disease and can be considered as an effective biomarker.

Association of melatonin and glutathione peroxidase enzyme in patients with type 2 diabetes mellitus

Diabetes mellitus (DM) is a group of diseases characterized by high blood glucose levels resulting from a defect in the body’s ability to produce and/or use insulin. It is believed that oxidative stress plays important role in the development of vascular complications in type 2 diabetes. The objectives: to determine the serum concentrations of endogenous melatonin and glutathione peroxidase (GPx) in cases of Type 2 DM and compare it with normal controls and to assess the correlation between melatonin and GPx. A case control study was done on 70 patients with diabetes mellitus type 2 according to ADA definition of DM type 2 recruited from Al Imamain Al-Kathemeaain medical city, Baghdad, Iraq who compared with 70 age, BMI and gender matched healthy control group in the levels of serum melatonin, serum glutathione peroxidase (GPx), fasting blood glucose (FBG) level, glycated hemoglobin (HbA1c), lipid profile, serum urea and serum creatinine. The activities of GPX enzyme (5.3021±1.2098) were significantly (p=0.037) lower than those of controls (6.6185±2.06877) which is accompanied with a significant reduction in the melatonin levels in patients (13.7652±2.75756) comparing with controls (17.3398±2.80153) with a significant positive correlation between GPX activity and melatonin levels in both patients and control groups. Inconclusions; melatonin levels showed to be reduced significantly in diabetic patient which may play an essential role in reducing the defense mechanism against ROS via affecting the activity of GPx enzyme.

Melatonin inhibits EMT and PD-L1 expression through the ERK1/2/FOSL1 pathway and regulates anti-tumor immunity in HNSCC.

Melatonin is an endogenous hormone with various biological functions and possesses anti‐tumor properties in multiple malignancies. Immune evasion is one of the most important hallmarks of head and neck squamous cell carcinoma (HNSCC) and is closely related to tumor progression. However, as an immune modulator under physiological conditions, the roles of melatonin in tumor immunity in HNSCC remains unclear. In this study, we found that the endogenous melatonin levels in patients with HNSCC were lower than those in patients with benign tumors in head and neck. Importantly, lower melatonin levels were related to lymph node metastasis among patients with HNSCC. Moreover, melatonin significantly suppressed programmed death‐ligand 1 (PD‐L1) expression and inhibited epithelial–mesenchymal transition (EMT) of HNSCC through the ERK1/2/FOSL1 pathway in vitro and in vivo. In SCC7/C3H syngeneic mouse models, anti‐programmed death‐1 (PD‐1) antibody combined with melatonin significantly inhibited tumor growth and modulated anti‐tumor immunity by increasing CD8+ T cell infiltration and decreasing the regulatory T cell (Treg) proportion in the tumor microenvironment. Taken together, melatonin inhibited EMT and downregulated PD‐L1 expression in HNSCC through the ERK1/2/FOSL1 pathway and exerted synergistic effects with anti‐PD‐1 antibody in vivo, which could provide promising strategies for HNSCC treatment.

Salivary Melatonin Changes in Oncological Patients: A Systematic Review.

Melatonin is known as a regulator of circadian sleep and waking rhythm. This hormone secreted by the pineal gland also has protective, oncostatic, and antioxidant properties. This systematic review was designed to answer the question “Is there a relationship between salivary melatonin changes and oncological diseases?”. Following the inclusion and exclusion criteria, ten studies were included, according to PRISMA statement guidelines. In all included studies, the diagnostic material was unstimulated whole saliva, in which the melatonin changes were determined by different laboratory methods. Most studies concerned changes in melatonin levels in patients with brain tumours due to a direct effect on the circadian rhythm centres. Other studies focused on disorders of melatonin secretion and its inclusion as a diagnostic marker in patients with prostate cancer and oral squamous cell carcinoma. The association between melatonin changes and sleep quality and chronotype in patients with newly diagnosed lung cancer and lymphoma survivors was also investigated. In conclusion, our systematic review may suggest trends for melatonin secretion alterations in oncological patients. However, due to the significant heterogeneity of the included reports, it is not possible to clearly determine a link between changes in salivary melatonin levels and the oncological diagnosis.

Relationship between physical activity, objective sleep parameters, and circadian rhythm in patients with head and neck cancer receiving chemoradiotherapy: A longitudinal study.

ObjectivesThis study was developed to assess the relationship between physical activity, sleep and circadian rhythm using accelerometer and urine melatonin levels in patients with head and neck cancer (HNC). Also, this study evaluated the changes in physical activity, sleep, and circadian rhythm during the seven‐week course of chemoradiotherapy.MethodsThis longitudinal study recruited 27 participants diagnosed with HNC who were planning to undergo chemoradiotherapy. Accelerometers worn for 3 days during the 1st, 3rd, and 7th weeks of chemoradiotherapy were used to assess physical activity levels (step count and metabolic equivalents [METs]) and sleep quality (total sleep time [TST], sleep onset latency [SOL], and sleep efficiency [SE]). Urine melatonin analysis was conducted using the morning void urine sample on 1st, 3rd, and 7th weeks. The change in variables during the seven weeks and the correlation between them were analyzed.ResultsDuring the seven weeks, trends of reduction in variables of physical activity, sleep and circadian rhythm were observed with significant decrease in step count, TST and melatonin levels. SE was found to have strong negative correlation with physical activity. TST was found to have moderate correlation with SE and step count. The variables of physical activity also showed moderate correlation among them.ConclusionThis study concludes that higher physical activity is associated with poor SE due to increased night‐time activity. There was a significant reduction in physical activity and sleep observed during seven weeks with moderate association between them. The significant circadian rhythm deregulation however showed poor association with the other variables.Level of Evidence: 2b

Melatonin level as a risk factor for age-related macular degeneration

Background. The current trend towards an increase in age-related macular degeneration (AMD) incidence rate in the population, including the working-age population, with a possible loss of professional activity, indicates the need for early preclinical identification of risk groups, timely prevention and treatment. In the prevention and treatment of AMD, the prospect of using melatonin is being actively discussed.Aim: to analyze serum and tear fluid levels of melatonin in patients with AMD and study their correlation with risk factors.Materials and methods. In the course of the study, two groups were formed: the main group - patients with non-exudative AMD and senile cataract (n = 40) and the reference group - conditionally healthy patients without AMD and cataract (n = 20). Patients of both groups were surveyed to identify risk factors for AMD. The content of melatonin in blood serum and lacrimal fluid was determined by enzyme-linked immunosorbent assay using the Melatonin ELISA Kit (USA).Results. In the course of the study, it was found that the concentration of melatonin in blood serum and tear fluid in patients with AMD was significantly lower than in patients of the reference group (p &lt;0.05). Serum and tear fluid melatonin levels depend on the following factors: age, body mass index (BMI), arterial hypertension, eye color, insomnia, and night work. It is possible that the local determination of melatonin in the lacrimal fluid can be a biomarker in the determination of ophthalmic pathological conditions.Conclusion. The obtained results can be used as recommendations for clarifying individual regimens for the use of melatonin, especially in the treatment of patients with AMD.

Effect of Retinohypothalamic Tract Dysfunction on Melatonin Level in Patients with Chronic Disorders of Consciousness.

Objective: The aim of this study is to compare the secretion level of nocturnal melatonin and the characteristics of the peripheral part of the visual analyzer in patients with chronic disorders of consciousness (DOC). Materials and Methods: We studied the level of melatonin in 22 patients with chronic DOC and in 11 healthy volunteers. The fundus condition was assessed using the ophthalmoscopic method. Results: The average level of nocturnal melatonin in patients with DOC differed by 80% from the level of indole in healthy volunteers. This reveals a direct relationship between etiology, the level of consciousness, gaze fixation, coma recovery scale-revised score and the level of melatonin secretion. Examination by an ophthalmologist revealed a decrease in the macular reflex in a significant number of DOC patients, which in turn correlates negatively with the time from brain injury and positively with low values of nocturnal melatonin.

Melatonin Levels in Patients with Nonalcoholic Fatty Liver Disease Compared with Healthy Individuals according to Fibrosis Level.

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is one of the most common diseases worldwide. Studies have shown that melatonin, as a regulatory hormone, is effective in different cell protective pathways. We aimed to compare serum melatonin levels of patients with NAFLD with different stages of fibrosis with that of healthy individuals. METHODS In this cross-sectional study patients, aged >20 years with elevated serum liver enzymes and trance abdominal sonographic diagnosis of fatty liver who met the exclusion criteria for NAFLD were included. The participants were categorized into three groups as follows: 1) severe fibrosis (fibrosis > 9.1 kPa and steatosis > 285 dbm), 2) mild-moderate fibrosis (fibrosis: 6-9.0 kPa and steatosis 240-285), and 3) normal group with fibrosis < 5.8 kPa and steatosis < 240 dbm based on Fibroscan evaluation. Five ml of fasting venous blood was taken from each patient and the control group for laboratory assessment. A questionnaire including demographic, anthropometric, laboratories (serum ALT, AST, triglyceride, total cholesterol and melatonin level), and clinical data was completed for all participants. RESULTS 97 people with a mean±SD age of 42.21 ± 11 years were enrolled. 59 (60.0%) patients were women. we observed that the melatonin levels were increased by advancing fibrosis. Based on control- attenuated parameter results the melatonin levels significantly differed between the healthy individuals and patients with severe steatosis. There was a direct association between increased melatonin levels and liver enzymes. CONCLUSION As a regulatory hormone, melatonin may directly be associated with liver cell injuries. Therefore, considered regulatory substances such as melatonin either diagnostic or therapeutic can improve the patients’ outcome.

Blood melatonin level can serve as a potential biomarker for prostate and hepatocellular carcinomas

Many systemic functions display circadian rhythms driven by an endogenous mechanism that is regulated by circadian-related genes and these gene expressions control a central clock in the brain and subordinate clocks in peripheral tissues. However, modern life has introduced environmental factors that often interfere with natural circadian rhythms. Importantly, circadian disruption has been identified as an independent risk factor of cancers. Melatonin is a major circadian rhythm regulator. In cancer patients, the rhythm of melatonin is often disrupted and its level is also reduced. These changes of melatonin impair its antioxidant and circadian regulatory functions on cells and tissues making them more susceptible to mutations and cancer initiation. In this context, the objectives of this study are to evaluate the sleep quality and blood levels of melatonin in patients with either prostate cancer (PC) or hepatocarcinoma (HCC) with the intent of using its levels as a potential biomarker of the cancers. The study involved 20 PC and 18 HCC patients, and 26 healthy volunteers. All blood samples were collected in the early morning, at 07:00 hours. Comparative sleep quality between PC, HCC patients and control subjects was acessed with a questionnaire, and melatonin and vitamin D were measured using conventional assays. The results revealed that patients with the worse sleep quality also had lower values of melatonin and vitamin D compared to control subjects. Notably, expression of melatonin-synthesizing enzymes and specific clock genes (PER, CRY and BMAL1) were significantly reduced and associated with worse prognosis in PC and HCC patients. These findings are consistent with the results of previous studies and suggest that disruption of the circadian rhythms, associated with changes in the light:dark cycle, has consequences for the maintenance of systemic health. We suggest that supplementation of melatonin and vitamin D may represent the important therapeutic strategies for patients with solid tumors for the purpose of improving their sleep quality and recuperative capacity.

Efficiency of Using Vita-melatonin in Patients with Non-alcoholic Fatty Liver Disease in Combination with Chronic Pancreatitis and Type 2 Diabetes Mellitus

The objective: to analyze the effectiveness and feasibility of complex therapy with the use of a melatonin preparation in patients with nonalcoholic fatty liver disease (NAFLD) in combination with chronic pancreatitis (CP) and type 2 diabetes mellitus (DM). Materials and methods. We examined 64 patients with NAFLD in combination with CP and type 2 diabetes (mean age – 48.9 ± 5.4 years). The control group included 20 practically healthy individuals: 12 (60.0 %) men and 8 (40.0 %) women (average age – 47.6 ± 5.8 years). The patients were divided into two groups depending on the prescribed treatment: Group I (n = 30) – patients received only basic therapy (BT), Group II (n = 34) – patients were prescribed melatonin in addition to BT (Vita-melatonin, firm PJSC «Kiev Vitamin Plant», Ukraine) at a dose of 3 mg per day 30 minutes before bedtime for 1 month. All patients with NAFLD in combination with CP and type 2 diabetes before and after treatment were examined by general clinical, anthropometric, instrumental and laboratory methods. To verify the diagnosis, attention was paid to the nature of the complaints, the medical history. Results. The results of the study make it possible to recommend the melatonin preparation as part of the complex treatment of patients with NAFLD in combination with CP and type 2 diabetes due to its antioxidant, anti-inflammatory properties, as well as its ability to influence cognitive changes in these patients. Conclusion. The drug melatonin (Vita-melatonin) is an effective, safe agent for the complex treatment of patients with NAFLD in combination with CP and type 2 diabetes. Normalization of the serum melatonin level in patients with NAFLD in combination with CP and type 2 diabetes with the use of melatonin leads to a decrease and / or normalization of the indicators of cognitive status in these patients.

Plasma melatonin levels in patients with diabetic retinopathy secondary to type 2 diabetes.

BACKGROUNDMelatonin is reported to be related to diabetes mellitus (DM) risk; however, the effect of melatonin on diabetic retinopathy (DR) risk remains unclear.AIMThe aim of this study was to determine the effect of melatonin on DR risk.METHODSA hospital-based case-control study was conducted from January 2020 to June 2020. DR was assessed using the Diabetic Retinopathy preferred practice pattern (PPP)-updated 2019 criteria. The participants were divided into the DM cases without DR (NDR) group, non-proliferative DR (NPDR) group and proliferative DR (PDR) group. Plasma melatonin concentration was detected with the enzyme-linked immunosorbent assay kit. The relationship between plasma melatonin concentration and DR risk as well as severity was assessed.RESULTSIt was found that plasma melatonin was 72.83 ± 16.25, 60.38 ± 13.43, 44.48 ± 10.30 and 44.69 ± 8.95 pg/mL in healthy controls, NDR group, NPDR and PDR group, respectively. In addition, it was found that plasma melatonin could be used as a potential diagnostic biomarker for DR (AUC = 0.893, P < 0.001). There was a significant positive relationship between total bilirubin and melatonin content (P < 0.001) based on the correlation assay. Significant associations between total bilirubin and melatonin content were also detected in the NPDR (R2 = 0.360, P < 0.001) and PDR (R2 = 0.183, P < 0.001) groups.CONCLUSIONThe data obtained in this study demonstrated that plasma melatonin concen-tration was decreased in DR cases and could be used as a sensitive and specific marker for the diagnosis of DR. A significant positive relationship between total bilirubin and melatonin was detected. More related studies are required to understand the role of melatonin in DR.