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褪黑素补充对美沙酮维持治疗患者心理健康、代谢和遗传特征的影响。

The effects of melatonin supplementation on mental health, metabolic and genetic profiles in patients under methadone maintenance treatment.

机构信息

Department of Addiction Studies, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

Addict Biol. 2019 Jul;24(4):754-764. doi: 10.1111/adb.12650. Epub 2018 Jun 27.

Abstract

This investigation was designed to determine the effect of melatonin supplementation on mental health parameters, metabolic and genetic profiles in patients under methadone maintenance treatment (MMT). This randomized, double-blind, placebo-controlled, clinical trial was conducted among 54 patients under MMT. Participants were randomly allocated to receive either 10 mg melatonin (2 melatonin capsules, 5 mg each) (n = 26) or placebo (n = 28) once a day, 1 hour before bedtime for 12 weeks. Melatonin supplementation significantly decreased Pittsburgh Sleep Quality Index (β -4.08; 95 percent CI, -5.51, -2.65; P < 0.001), Beck Depression Inventory index (β -5.46; 95% CI, -8.92, -2.00; P = 0.003) and Beck Anxiety Inventory index (β -3.87; 95% CI, -5.96, -1.77; P = 0.001) and significantly increased International Index of Erectile Functions (β 5.59; 95% CI, 1.76, 9.42; P = 0.005) compared with the placebo. Subjects who received melatonin supplements had significantly lower serum insulin levels (β -2.53; 95% CI, -4.48, -0.59; P = 0.01), homeostasis model of assessment-insulin resistance (β -0.56; 95% CI, -1.03, -0.09; P = 0.01) and higher quantitative insulin sensitivity check index (β 0.01; 95% CI, 0.004, 0.02; P = 0.009) and HDL-cholesterol levels (β 3.71; 95% CI, 1.77, 5.64; P = 0.002) compared to placebo. Additionally, melatonin intake resulted in a significant reduction in serum high sensitivity C-reactive protein (β -0.15; 95% CI, -0.27, -0.02; P = 0.02), malondialdehyde (β -0.31; 95% CI, -0.57, -0.05; P = 0.02) and protein carbonyl (β -0.06; 95% CI, -0.09, -0.04; P < 0.001). This trial indicated that taking melatonin supplements for 12 weeks by patients under MMT had beneficial effects on their mental health metabolic profiles.

摘要

这项研究旨在探讨褪黑素补充剂对美沙酮维持治疗(MMT)患者心理健康参数、代谢和遗传特征的影响。这是一项随机、双盲、安慰剂对照的临床试验,共纳入 54 名 MMT 患者。参与者被随机分配接受 10mg 褪黑素(2 粒褪黑素胶囊,每粒 5mg)(n=26)或安慰剂(n=28),每天睡前 1 小时服用 1 次,共 12 周。褪黑素补充剂显著降低匹兹堡睡眠质量指数(β-4.08;95%置信区间,-5.51,-2.65;P<0.001)、贝克抑郁指数(β-5.46;95%置信区间,-8.92,-2.00;P=0.003)和贝克焦虑指数(β-3.87;95%置信区间,-5.96,-1.77;P=0.001),同时显著提高国际勃起功能指数(β 5.59;95%置信区间,1.76,9.42;P=0.005),与安慰剂相比。接受褪黑素补充剂的受试者血清胰岛素水平显著降低(β-2.53;95%置信区间,-4.48,-0.59;P=0.01),胰岛素抵抗评估的稳态模型(β-0.56;95%置信区间,-1.03,-0.09;P=0.01),而定量胰岛素敏感性检查指数(β 0.01;95%置信区间,0.004,0.02;P=0.009)和高密度脂蛋白胆固醇水平(β 3.71;95%置信区间,1.77,5.64;P=0.002)则显著升高。此外,褪黑素摄入可显著降低血清高敏 C 反应蛋白(β-0.15;95%置信区间,-0.27,-0.02;P=0.02)、丙二醛(β-0.31;95%置信区间,-0.57,-0.05;P=0.02)和蛋白质羰基(β-0.06;95%置信区间,-0.09,-0.04;P<0.001)水平。本试验表明,MMT 患者连续服用 12 周褪黑素补充剂对其心理健康和代谢特征有有益影响。

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