Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran.
Inflammopharmacology. 2018 Aug;26(4):899-907. doi: 10.1007/s10787-018-0508-7. Epub 2018 Jun 15.
This systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out to determine the effect of melatonin supplementation on the inflammatory markers among individuals with metabolic syndrome (MetS) and related disorders.
We searched the following databases up to March 2018: PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. Three reviewers independently assessed study eligibility, extracted data, and evaluated risk of bias of included primary studies. Statistical heterogeneity was assessed using Cochran's Q test and I-square (I) statistic. Data were pooled using the random effect model and standardized mean difference (SMD) was considered as the summary effect size.
Six trials of 317 potential reports were identified to be suitable for our meta-analysis. The pooled results using random effects model indicated that melatonin supplementation significantly reduced C-reactive protein (CRP) (SMD = - 1.80; 95% CI - 3.27, - 0.32; P = 0.01; I: 95.2) and interleukin 6 (IL-6) concentrations (SMD = - 2.02; 95% CI - 3.57, - 0.47; P = 0.01; I: 91.2) among patients with MetS and related disorders; however, it did not affect tumor necrosis factor-α (TNF-α) concentrations (SMD = - 1.87; 95% CI - 3.81, 0.07; P = 0.05; I: 94.4).
In summary, the current meta-analysis showed the promising effect of melatonin administration on reducing CRP and IL-6, but not TNF-α levels among patients with MetS and related disorders. Additional prospective studies are recommended using higher supplementation doses and longer intervention period.
本系统评价和荟萃分析对随机对照试验（RCT）进行了研究，旨在确定褪黑素补充剂对代谢综合征（MetS）和相关疾病患者的炎症标志物的影响。
我们搜索了以下数据库，截至 2018 年 3 月：PubMed、MEDLINE、EMBASE、Web of Science 和 Cochrane 对照试验中心注册库。三名评审员独立评估了研究的合格性、提取数据，并评估了纳入的主要研究的偏倚风险。使用 Cochran's Q 检验和 I 平方（I）统计量评估了统计异质性。使用随机效应模型汇总数据，并考虑标准化均数差（SMD）作为汇总效应量。
从 317 份潜在报告中确定了 6 项适合我们荟萃分析的试验。使用随机效应模型的汇总结果表明，褪黑素补充剂可显著降低 CRP（SMD=-1.80；95%CI-3.27，-0.32；P=0.01；I：95.2）和白细胞介素 6（IL-6）浓度（SMD=-2.02；95%CI-3.57，-0.47；P=0.01；I：91.2），但对肿瘤坏死因子-α（TNF-α）浓度无影响（SMD=-1.87；95%CI-3.81，0.07；P=0.05；I：94.4）。
综上所述，本荟萃分析显示褪黑素给药在降低 MetS 和相关疾病患者的 CRP 和 IL-6 水平方面具有良好的效果，但对 TNF-α 水平无影响。建议进行更多使用更高补充剂量和更长干预时间的前瞻性研究。
