Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm
Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm
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DOI：
10.3109/0886022x.2014.926216
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发表时间：
2014-08-01
期刊：
影响因子：
3
通讯作者：
Stefanidis, Ioannis
中科院分区：
文献类型：
--
作者：
Bouchlariotou, Sofia;Liakopoulos, Vassilios;Stefanidis, Ioannis
无昼夜节律血压(BP)是先兆子痫的常见发现，并伴有不良后果。褪黑素在生物昼夜节律中起着关键作用。本研究探讨了子痫前期患者褪黑激素分泌与血压昼夜节律的关系。病例是2006年1月至2007年6月在拉里萨大学医院治疗的先兆子痫妇女。正常妊娠的志愿者，年龄和胎龄匹配，作为对照。24小时动态血压监测。采用双抗体夹心酶联免疫法测定昼夜血褪黑素和尿液6-硫氧基黑素水平。产后2个月重复测量。31名先兆子痫妇女和20名对照组包括在内。在31名先兆子痫患者中，有21名是非勺型。与正常妊娠相比，子痫前期患者夜间褪黑素水平显著降低(48.4pg/mlvs.85.4pg/mlvs.85.4pg/mlvs.26.9pg/mLp<；0.001)。对昼夜血压节律状态的调整将这一发现完全归因于非勺型(p<；0.01)。产后2个月，21例非勺型孕妇中有11例血压昼夜节律和褪黑素分泌节律均恢复正常。相反，在保持非浸泡状态(n=10)的患者中，褪黑激素的分泌节律仍然受损：白天与夜间褪黑素(33.5pg/m l+/-13.0pg/m l比28.0+/-13.8pg/m L，p=0.386)。总体而言，尿液6-硫氧基黑素水平与血清褪黑素水平相似。妊娠期和产后至少2个月的先兆子痫患者血压和褪黑激素的昼夜节律是平行的。我们的发现可能不足以暗示褪黑素的潜在治疗作用，然而，他们明确强调，褪黑素参与了子痫前期非降压的发病机制，需要深入的进一步研究。
Non-dipping circadian blood pressure (BP) is a common finding in preeclampsia, accompanied by adverse outcomes. Melatonin plays pivotal role in biological circadian rhythms. This study investigated the relationship between melatonin secretion and circadian BP rhythm in preeclampsia. Cases were women with preeclampsia treated between January 2006 and June 2007 in the University Hospital of Larissa. Volunteers with normal pregnancy, matched for chronological and gestational age, served as controls. Twenty-four hour ambulatory BP monitoring was applied. Serum melatonin and urine 6-sulfatoxymelatonin levels were determined in day and night time samples by enzyme-linked immunoassays. Measurements were repeated 2 months after delivery. Thirty-one women with preeclampsia and 20 controls were included. Twenty-one of the 31 women with preeclampsia were non-dippers. Compared to normal pregnancy, in preeclampsia there were significantly lower night time melatonin (48.4 +/- 24.7 vs. 85.4 +/- 26.9 pg/mL, p < 0.001) levels. Adjustment for circadian BP rhythm status ascribed this finding exclusively to non-dippers (p < 0.01). Two months after delivery, in 11 of the 21 non-dippers both circadian BP and melatonin secretion rhythm reappeared. In contrast, in cases with retained non-dipping status (n=10) melatonin secretion rhythm remained impaired: daytime versus night time melatonin (33.5 +/- 13.0 vs. 28.0 +/- 13.8 pg/mL, p=0.386). Urinary 6-sulfatoxymelatonin levels were, overall, similar to serum melatonin. Circadian BP and melatonin secretion rhythm follow parallel course in preeclampsia, both during pregnancy and, at least 2 months after delivery. Our findings may be not sufficient to implicate a putative therapeutic effect of melatonin, however, they clearly emphasize that its involvement in the pathogenesis of a non-dipping BP in preeclampsia needs intensive further investigation.