围绝经期和绝经后女性体内的褪黑素：与情绪、睡眠、更年期症状及生活质量的关联
Melatonin in perimenopausal and postmenopausal women: associations with mood, sleep, climacteric symptoms, and quality of life.
作者信息
Toffol Elena, Kalleinen Nea, Haukka Jari, Vakkuri Olli, Partonen Timo, Polo-Kantola Päivi
机构信息
From the 1Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare THL, Helsinki, Finland; 2Department of Psychiatry, University of Helsinki, Helsinki, Finland; 3Sleep Research Unit, Department of Physiology, University of Turku, Turku, Finland; 4Heart Center, Turku University Hospital, and University of Turku, Turku, Finland; 5Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland; 6Institute of Biomedicine, University of Oulu, Oulu, Finland; and 7Department of Obstetrics and Gynecology, Turku University Hospital, and University of Turku, Turku, Finland.
出版信息
Menopause. 2014 May;21(5):493-500. doi: 10.1097/GME.0b013e3182a6c8f3.
OBJECTIVE
Melatonin synthesis and secretion are partly modulated by estrogen and progesterone. Changes in melatonin concentrations, possibly related to the menopausal transition, may be associated with climacteric mood, sleep, and vasomotor symptoms. The aims of this study were to compare the serum concentrations of melatonin in perimenopausal and postmenopausal women and to evaluate melatonin's influence on mood, sleep, vasomotor symptoms, and quality of life.
METHODS
We analyzed the data of 17 healthy perimenopausal women (aged 43-51 y) and 18 healthy postmenopausal women (aged 58-71 y) who participated in a prospective study. On study night (9:00 pm-9:00 am), serum melatonin was sampled at 20-minute (9:00 pm-12:00 midnight; 6:00-9:00 am) and 1-hour (12:00 midnight-6:00 am) intervals. Questionnaires were used to assess depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), insomnia and sleepiness (Basic Nordic Sleep Questionnaire [BNSQ]), subjective sleep quality, vasomotor symptoms, and quality of life (EuroQoL).
RESULTS
Postmenopausal women had lower nighttime serum melatonin concentrations than perimenopausal women. The duration of melatonin secretion tended to be shorter in postmenopause, whereas melatonin peak time did not differ. Mean melatonin concentrations and exposure levels did not correlate with follicle-stimulating hormone level, estradiol level, body mass index, Beck Depression Inventory score, State-Trait Anxiety Inventory score, BNSQ insomnia score, BNSQ sleepiness score, subjective sleep score, climacteric vasomotor score, or quality of life. In perimenopause, the later is the melatonin peak, the higher is the level of anxiety (P = 0.022), and the longer is the melatonin secretion, the better is the quality of life (P < 0.001).
CONCLUSIONS
Longitudinal research is needed to better understand the possible contributory role of menopause in lower melatonin levels.
目的
褪黑素的合成与分泌部分受雌激素和孕激素调节。褪黑素浓度的变化可能与绝经过渡有关，可能与更年期的情绪、睡眠及血管舒缩症状相关。本研究旨在比较围绝经期和绝经后女性血清褪黑素浓度，并评估褪黑素对情绪、睡眠、血管舒缩症状及生活质量的影响。
方法
我们分析了参与一项前瞻性研究的17名健康围绝经期女性（年龄43 - 51岁）和18名健康绝经后女性（年龄58 - 71岁）的数据。在研究当晚（晚上9:00至上午9:00），每隔20分钟（晚上9:00至午夜12:00；上午6:00至9:00）和1小时（午夜12:00至上午6:00）采集血清褪黑素样本。使用问卷评估抑郁（贝克抑郁量表）、焦虑（状态-特质焦虑量表）、失眠和嗜睡（北欧基本睡眠问卷[BNSQ]）、主观睡眠质量、血管舒缩症状及生活质量（欧洲生活质量量表）。
结果
绝经后女性夜间血清褪黑素浓度低于围绝经期女性。绝经后褪黑素分泌持续时间倾向于更短，而褪黑素峰值时间无差异。平均褪黑素浓度和暴露水平与促卵泡激素水平、雌二醇水平、体重指数、贝克抑郁量表评分、状态-特质焦虑量表评分、BNSQ失眠评分、BNSQ嗜睡评分、主观睡眠评分、更年期血管舒缩评分或生活质量均无相关性。在围绝经期，褪黑素峰值出现越晚，焦虑水平越高（P = 0.022），褪黑素分泌时间越长，生活质量越好（P < 0.001）。
结论
需要进行纵向研究以更好地理解绝经在较低褪黑素水平中可能的促成作用。
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