Decreased melatonin secretion in patients with glaucoma: Quantitative association with glaucoma severity in the LIGHT study
Decreased melatonin secretion in patients with glaucoma: Quantitative association with glaucoma severity in the LIGHT study
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DOI：
10.1111/jpi.12662
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发表时间：
2020-05-27
影响因子：
10.3
通讯作者：
Ogata, Nahoko
中科院分区：
文献类型：
--
作者：
Yoshikawa, Tadanobu;Obayashi, Kenji;Ogata, Nahoko
青光眼可能与昼夜节律紊乱有关，这是由于其与固有光敏视网膜神经节细胞的丧失有关。证明青光眼和昼夜节律紊乱之间相关性的临床证据有限，尚未进行大规模研究。这项横断面研究的目的是确定青光眼的存在和严重程度是否与尿6-硫酸氧褪黑激素水平作为昼夜节律参数相关。我们测量了118名青光眼患者和395名非青光眼对照者的尿6-硫酸氧褪黑素排泄（UME）水平。青光眼组的UME显著低于无青光眼的对照组（分别为3.05和3.24 log ng/mg肌酐; P = 0.010）。接下来，我们研究了青光眼的严重程度和褪黑激素水平之间的关系。在青光眼组的分层分析中，校正潜在混杂因素的多变量线性回归分析表明，功能性重度青光眼患者的UME显著降低0.30 log ng/mg肌酐（视野平均偏差-6dB; P = .040），UME降低0.05 log ng/视乳头周围视网膜神经纤维层厚度每变薄10 μ m，作为青光眼结构严重程度的指标（P = .011）。总之，青光眼与低尿6-硫酸氧褪黑激素水平显著相关。此外，功能性和结构性严重青光眼患者与低尿6-硫酸氧褪黑激素水平显著相关。我们的研究结果表明青光眼患者昼夜节律紊乱的可能性。
Glaucoma may be associated with circadian disruption due to its association with a loss of intrinsically photosensitive retinal ganglion cells. Clinical evidence demonstrating an association between glaucoma and circadian disruption is limited, and no large-scale studies have been performed. The purpose of this cross-sectional study was to determine whether the presence and severity of glaucoma is correlated with the urinary 6-sulfatoxymelatonin levels as a circadian rhythm parameter. We measured the level of urinary 6-sulfatoxymelatonin excretion (UME) in 118 glaucoma patients and 395 control participants without glaucoma. The UME in the glaucoma group was significantly lower than that of the control group without glaucoma (3.05 and 3.24 log ng/mg creatinine, respectively; P = .010). Next, we examined association of the severity of glaucoma and melatonin levels. In stratification analysis of the glaucoma groups, multivariable linear regression analyses adjusted for potential confounders indicated significantly lower UME by 0.30 log ng/mg creatinine in patients with functional severe glaucoma (visual field mean deviation -6 dB; P = .040) and lower UME by 0.05 log ng/mg creatinine with each 10 mu m thinning of the circumpapillary retinal nerve fiber layer thickness as the index of structural severity of glaucoma (P = .011). In conclusion, significant association between glaucoma and lower urinary 6-sulfatoxymelatonin was found. In addition, patients with functional and structural severe glaucoma were significantly associated with lower urinary 6-sulfatoxymelatonin levels. Our results indicate the possibility of a circadian disruption in patients with glaucoma.