Impaired nocturnal melatonin secretion in non-dipper hypertensive patients
Impaired nocturnal melatonin secretion in non-dipper hypertensive patients
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DOI：
10.1080/08037050310000418
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发表时间：
2003-01-01
期刊：
影响因子：
1.8
通讯作者：
Grossman, E
中科院分区：
文献类型：
--
作者：
Jonas, M;Garfinkel, D;Grossman, E
背景：褪黑素在昼夜节律的生物调节中起作用，包括睡眠。褪黑素也被证明可以调节血管平滑肌张力并诱导人体的血流动力学效应。目的：探讨褪黑素在高血压患者血压昼夜节律中的作用。方法：对16例老年原发性高血压患者进行评价。根据夜间平均动脉压（MAP）的变化将患者定义为倾斜者（DIP, n = 8）或非倾斜者（NDIP, n = 8）。采用酶联免疫吸附法（ELISA）测定白天和夜间两组尿液中主要褪黑素代谢物6-硫代氧褪黑素（6-SMT）的含量。结果：两组DIP和NDIP高血压患者在年龄和性别方面具有可比性。夜间，DIP组平均动脉压下降10.3 +/- 2.2%，NDIP组平均动脉压升高7.5 +/- 1.7% （p < 0.01）。每日6-SMT在DIP （3.28 +/- 0.87 μg/12 h）和NDIP （2.31 +/- 0.68 μg/12 h）中具有可同性（p = 0.39）。然而，虽然DIP表现出夜间尿6-SMT的生理性增加（平均8.19 +/- 1.68 μg/12 h），但在NDIP中却没有这种褪黑激素产生的激增，NDIP组夜间尿6-SMT浓度与日常水平没有显著差异（平均2.56 +/- 0.79 μg/12 h）。尿6-SMT夜间排泄量变化与夜间MAP变化呈正相关（R = 0.54; p = 0.031）。结论：NDIP高血压患者与DIP高血压患者的不同之处在于夜间褪黑素分泌受损。因此，褪黑素可能在高血压患者的血压昼夜节律中发挥作用。
Background: Melatonin plays a role in the biologic regulation of circadian rhythms, including sleep. Melatonin has also been shown to modulate vascular smooth muscle tone and to induce hemodynamic effects in humans. Objective: To evaluate whether melatonin plays a role in the circadian rhythm of blood pressure in hypertensive patients. Methods: Sixteen elderly patients with essential hypertension were evaluated. Patients were defined as either dippers (DIP, n = 8) or non-dippers (NDIP, n = 8) according to the nocturnal change in the mean arterial pressure (MAP). 6-Sulfatoxymelatonin (6-SMT), the main melatonin metabolite, was determined by enzyme-linked immunosorbent assay (ELISA) in two separate urine collections, one in the daytime and one during the night. Results: Both groups of DIP and NDIP hypertensives were comparable in regard to age and sex. During the night, the mean arterial pressure decreased by 10.3 +/- 2.2% in the DIP and increased by 7.5 +/- 1.7% in the NDIP group (p < 0.01). Daily 6-SMT was comparable in DIP (3.28 +/- 0.87 μg/12 h) and NDIP (2.31 +/- 0.68 μg/12 h) (p = 0.39). However, while the DIP presented the physiological nocturnal increase in urinary 6-SMT (mean 8.19 +/- 1.68 μg/12 h), this surge of melatonin production was missing in NDIP in whom nocturnal urinary 6-SMT concentrations were not significantly different from daily levels (mean 2.56 +/- 0.79 μg/12 h). The nocturnal change in urinary 6-SMT excretion was positively correlated to the nocturnal change in MAP (R = 0.54; p = 0.031). Conclusions: NDIP hypertensive patients differ from DIP hypertensives by having an impaired nocturnal melatonin secretion. Thus, melatonin may play a role in the circadian rhythm of blood pressure in hypertensive patients.