Melatonin Levels in Preterm and Term Infants and Their Mothers
Melatonin Levels in Preterm and Term Infants and Their Mothers
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DOI：
10.3390/ijms20092077
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发表时间：
2019-05-01
影响因子：
5.6
通讯作者：
Baud, Olivier
中科院分区：
文献类型：
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作者：
Biran, Valerie;Decobert, Fabrice;Baud, Olivier
预防早产后的围产期脑损伤仍然是公共卫生的优先事项。褪黑激素已被证明是一种有前途的神经保护剂，在新生儿脑损伤的临床前模型，但很少有研究调查褪黑激素在新生儿的分泌。我们假设早产儿的褪黑激素循环水平低于足月儿。我们进行了一项前瞻性、纵向、多中心研究，通过放射免疫测定法评估褪黑激素和6-硫酸氧-褪黑激素（aMT 6s）浓度。在209名新生儿中，110名出生于34孕周（GW）之前，99名出生于34 GW之后。出生时和第3天测量的血浆褪黑激素浓度分别低于78%和81%的可检测水平（7 pg/mL），34 GW之前出生的婴儿分别为57%和34%，34 GW之后出生的婴儿分别为57%和34%。血浆褪黑激素浓度的分布与两个时间点的胎龄相关（p < 0.001）。在34 GW之前出生的婴儿中，第1天（230 ng/L vs. 533 ng/L，p < 0.0001）和第3天（197 ng/L vs. 359 ng/L，p < 0.0001）的中位尿aMT 6s浓度显著较低。总之，褪黑激素分泌似乎非常低，早产儿，提供了测试补充褪黑激素作为神经保护剂在临床试验的基本原理。
The prevention of perinatal brain damage following preterm birth remains a public health priority. Melatonin has been shown to be a promising neuroprotectant in neonatal preclinical models of brain damage, but few studies have investigated melatonin secretion in newborns. We hypothesized that melatonin circulating levels would be lower in preterm compared to term infants. We conducted a prospective, longitudinal, multicenter study to assess melatonin, and 6-sulfatoxy-melatonin (aMT6s) concentrations, measured by radioimmunoassay. Among 209 neonates recruited, 110 were born before 34 gestational weeks (GW) and 99 born after 34 GW. Plasma melatonin concentrations, measured at birth and on Day 3 were below detectable levels (7 pg/mL) in 78% and 81%, respectively, of infants born before 34 GW compared to 57% and 34%, respectively, of infants born after 34 GW. The distribution of plasma melatonin concentrations was found to be correlated with gestational age at both time-points (p < 0.001). Median urine aMT6s concentrations were significantly lower in infants born before 34 GW, both on Day 1 (230 ng/L vs. 533 ng/L, p < 0.0001) and on Day 3 (197 ng/L vs. 359 ng/L, p < 0.0001). In conclusion, melatonin secretion appears very low in preterm infants, providing the rationale for testing supplemental melatonin as a neuroprotectant in clinical trials.