Serum melatonin levels in adolescent idiopathic scoliosis prediction and prevention for curve progression - a prospective study
Serum melatonin levels in adolescent idiopathic scoliosis prediction and prevention for curve progression - a prospective study
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DOI：
10.1111/j.1600-079x.2009.00669.x
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发表时间：
2009-04-01
影响因子：
10.3
通讯作者：
Kimura, Jun
中科院分区：
文献类型：
--
作者：
Machida, Masafumi;Dubousset, Jean;Kimura, Jun
在40名患有中重度特发性脊柱侧凸的青少年患者中，研究了血清褪黑激素水平与青少年特发性脊柱侧凸曲线进展的相关性，以及褪黑激素治疗对内源性褪黑激素水平降低的脊柱侧凸患者的影响。在脊柱侧凸受试者中，28例为稳定性脊柱侧凸，12例为进行性脊柱侧凸。正常褪黑激素水平来自25名年龄匹配的对照患者。脊柱侧凸患者的血清褪黑激素水平每年监测一次，为期3至6年，揭示了一个昼夜模式，白天值低，晚上高。正常水平的脊柱侧凸患者不接受治疗或接受支具治疗，除两名内源性褪黑激素水平低的患者外，所有患者均接受吲哚口服补充剂治疗。在22名褪黑激素水平正常的患者中，16名患有稳定性脊柱侧凸，6名患有进行性脊柱侧凸。在16名接受低褪黑激素治疗的患者中，12名患者的脊柱侧凸稳定，4名患者的病程进展。两例未治疗病例的病程进展。在12名患有进行性脊柱侧凸的患者中，9名在初次检查时弯曲度> 35度。这些发现表明，褪黑激素缺乏在特发性脊柱侧凸的预后中起着重要作用。因此，补充褪黑激素可以防止脊柱侧凸的进展，特别是在弯曲度小于35度的轻度病例中。
The correlation of serum melatonin levels and curve progression in adolescent idiopathic scoliosis, and the effects of melatonin therapy in scoliotic patients with reduced levels of endogenous melatonin were studied in 40 adolescent patients with moderate to severe idiopathic scoliosis. Of the scoliotic subjects, 28 had stable scoliosis and 12 had progressive scoliosis. Normal melatonin levels were derived from 25 age-matched control patients. Serum melatonin levels were monitored yearly in scoloiotic patients for a period ranging from 3 to 6 yr, revealing a diurnal pattern with low values during the day and high at night. Scoliotic patients with normal levels were not treated or were treated with a brace, and all but two patients with low endogenous melatonin were treated with oral supplements of the indole. Of the 22 patients with a normal melatonin level, 16 had stable scoliosis and six had progressive scoliosis. Of the 16 patients treated for a low melatonin level, 12 had stable scoliosis and four had a progressive course. The two untreated cases had a progressive course. Of the 12 patients who had progressive scoliosis, nine had > 35 degrees of curve at initial examination. These findings suggest that melatonin deficiency plays a role in the prognosis of idiopathic scoliosis. Therefore, melatonin supplements may prevent the progression of scoliosis, especially in mild cases with less than a 35 degrees curve.