Melatonin levels in women with fibromyalgia and chronic fatigue syndrome.
Melatonin levels in women with fibromyalgia and chronic fatigue syndrome.
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发表时间：
1999-12
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通讯作者：
A. Korszun;L. Sackett-Lundeen;E. Papadopoulos;Christine B. Brucksch;L. Masterson;Engelberg Nc;E. Haus;M. Demitrack;L. Crofford
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作者：
A. Korszun;L. Sackett-Lundeen;E. Papadopoulos;Christine B. Brucksch;L. Masterson;Engelberg Nc;E. Haus;M. Demitrack;L. Crofford
目的纤维肌痛（FM）和慢性疲劳综合征（CFS）是主要影响女性的应激相关疾病。FM的主要特征是广泛的肌肉骨骼疼痛，CFS是严重的衰弱性疲劳，但这两种综合征之间的临床症状有相当大的重叠。神经内分泌异常已注意到在FM和CFS和昼夜节律系统的deserminization已被假定在其病因。松果体激素褪黑激素参与同步昼夜节律系统，外源性褪黑激素的使用在FM和CFS患者中已变得普遍。方法：研究绝经前女性FM（n = 9）和CFS（n = 8）患者的褪黑素和皮质醇水平，并与年龄和月经周期相匹配的对照组进行比较。在24 h内，每10 min从留置静脉导管中采集血液，并分别以60 min和10 min的间隔通过放射免疫法测定血浆褪黑激素和皮质醇。结果FM患者夜间（23：00-06：50）血浆褪黑素水平显著高于对照组（p<0.05），CFS患者与对照组间褪黑素水平无显著差异。与对照组相比，两组患者的皮质醇和褪黑激素分泌模式的时间无差异，两种节律的内部去极化也无差异。结论在其他几种与神经内分泌轴失调相关的疾病中，血浆褪黑素浓度升高。褪黑激素水平的增加可能代表对应激诱导的下丘脑破坏的易感性增加的标志。这些数据表明，没有理由褪黑激素替代治疗FM和CFS患者。
OBJECTIVE Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are stress associated disorders mainly affecting women. FM is characterized primarily by widespread musculoskeletal pain, and CFS by profound debilitating fatigue, but there is considerable overlap of clinical symptoms between these 2 syndromes. Neuroendocrine abnormalities have been noted in both FM and CFS and desynchronization of circadian systems has been postulated in their etiology. The pineal hormone melatonin is involved in synchronizing circadian systems and the use of exogenous melatonin has become widespread in patients with FM and CFS. METHODS We examined the characteristics and relationship of melatonin and cortisol levels in premenopausal women with FM (n = 9) or CFS (n = 8), compared to age and menstrual cycle phase matched controls. Blood was collected from an indwelling intravenous catheter every 10 min over 24 h, and plasma melatonin and cortisol were determined by radioimmunoassay at 60 and 10 min intervals, respectively. RESULTS Night time (23:00-06:50) plasma melatonin levels were significantly higher in FM patients compared to controls (p<0.05), but there was no significant difference in melatonin levels between CFS patients and controls. No differences in the timing of cortisol and melatonin secretory patterns and no internal desynchronization of the 2 rhythms were found in either patient group, compared to controls. CONCLUSION Raised plasma melatonin concentrations have been documented in several other conditions that are associated with dysregulation of neuroendocrine axes. Increased melatonin levels may represent a marker of increased susceptibility to stress induced hypothalamic disruptions. These data indicate that there is no rationale for melatonin replacement therapy in patients with FM and CFS.