Melatonin Secretion and the Incidence of Type 2 Diabetes
Melatonin Secretion and the Incidence of Type 2 Diabetes
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DOI：
10.1001/jama.2013.2710
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发表时间：
2013-04-03
影响因子：
120.7
通讯作者：
Forman, John P.
中科院分区：
文献类型：
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作者：
McMullan, Ciaran J.;Schernhammer, Eva S.;Forman, John P.
重要的是褪黑素受体功能丧失突变与胰岛素抵抗和2型糖尿病有关。此外，在一项对非糖尿病患者的横断面分析中，夜间褪黑激素分泌减少与胰岛素抵抗增加有关。目的研究褪黑激素分泌与2型糖尿病发病风险的关系。设计、设置和参与者纳入护士健康研究队列。在2000年提供尿样和血样的非糖尿病参与者中，我们确定了370名在2000-2012年间发展为2型糖尿病的女性，并使用风险集抽样与370名对照组进行了匹配。主要观察指标采用多变量条件Logistic回归方法，控制人口学特征、生活习惯、睡眠质量指标以及炎症和内皮功能障碍的生物标志物，评估基线水平褪黑素分泌与2型糖尿病发病率之间的关系。结果尿液中6-硫氧肌醇与肌酐的中位数比率为28.2 ng/mg(5%-95%范围，对照组为36.3 ng/mg(5%~95%，6.9~110.8 ng/mg)。6-硫酸盐/肌酐比值较低的女性患糖尿病的风险较高(多变量优势比1.48[95%CI，1.11-1.98]在6-硫酸盐/肌酐的估计对数比中每单位下降1.48[95%CI，1.11-1.98])。与6-硫酸盐/肌酐比值最高组的女性相比，最低组患2型糖尿病的多变量优势比为2.17(95%CI，1.18-3.98)。褪黑素分泌量最高的女性糖尿病发病率估计为4.27例/1000人年，而褪黑素分泌量最低的女性糖尿病发病率为9.27例/1000人年。结论褪黑素分泌量低与患2型糖尿病的风险独立相关。有必要进行进一步的研究，以评估褪黑激素分泌是否是普通人群中糖尿病的一个可改变的危险因素。贾玛2013；309(13)：1388-1396 www.jama.com
Importance Loss-of-function mutations in the melatonin receptor are associated with insulin resistance and type 2 diabetes. Additionally, in a cross-sectional analysis of persons without diabetes, lower nocturnal melatonin secretion was associated with increased insulin resistance.Objective To study the association between melatonin secretion and the risk of developing type 2 diabetes.Design, Setting, and Participants Case-control study nested within the Nurses' Health Study cohort. Among participants without diabetes who provided urine and blood samples at baseline in 2000, we identified 370 women who developed type 2 diabetes from 2000-2012 and matched 370 controls using risk-set sampling.Main Outcome Measures Associations between melatonin secretion at baseline and incidence of type 2 diabetes were evaluated with multivariable conditional logistic regression controlling for demographic characteristics, lifestyle habits, measures of sleep quality, and biomarkers of inflammation and endothelial dysfunction.Results The median urinary ratios of 6-sulfatoxymelatonin to creatinine were 28.2 ng/mg (5%-95% range, 5.5-84.2 ng/mg) among cases and 36.3 ng/mg (5%-95% range, 6.9-110.8 ng/mg) among controls. Women with lower ratios of 6-sulfatoxymelatonin to creatinine had increased risk of diabetes (multivariable odds ratio, 1.48 [95% CI, 1.11-1.98] per unit decrease in the estimated log ratio of 6-sulfatoxymelatonin to creatinine). Compared with women in the highest ratio category of 6-sulfatoxymelatonin to creatinine, those in the lowest category had a multivariable odds ratio of 2.17 (95% CI, 1.18-3.98) of developing type 2 diabetes. Women in the highest category of melatonin secretion had an estimated diabetes incidence rate of 4.27 cases/1000 person-years compared with 9.27 cases/1000 person-years in the lowest category.Conclusions and Relevance Lower melatonin secretion was independently associated with a higher risk of developing type 2 diabetes. Further research is warranted to assess if melatonin secretion is a modifiable risk factor for diabetes within the general population. JAMA. 2013;309(13):1388-1396 www.jama.com