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老年人群中褪黑素分泌与糖尿病相关性的性别差异:HEIJO-KYO 队列研究。

Gender differences in the association between melatonin secretion and diabetes in elderly: The HEIJO-KYO cohort.

机构信息

Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.

Department of Nursing, Tenri Health Care University, Nara, Japan.

出版信息

Clin Endocrinol (Oxf). 2018 Dec;89(6):750-756. doi: 10.1111/cen.13842. Epub 2018 Sep 24.

Abstract

OBJECTIVE

Reportedly, melatonin protects the pancreatic islets and decreases insulin resistance; thus, it may contribute to preventing diabetes. Epidemiological data suggested that lower melatonin secretion is associated with higher incidence of diabetes in female nurses. Such associations are unknown in the general population. We evaluated the association between melatonin secretion and diabetes in a general population, including both genders.

DESIGN

Cross-sectional study.

PARTICIPANTS

A total of 1096 community-based elderly males (n = 519) and females (n = 577) (mean age, 71.8 years) were enrolled.

MEASUREMENTS

Overnight urinary 6-sulfatoxymelatonin excretion (UME) and diabetes prevalence were measured.

RESULTS

The median UME was 6.7 μg (interquartile range, 4.0-10.5); the prevalence of diabetes was 17.5% in males and 10.7% in females. The prevalence of diabetes decreased with increasing UME quartiles among males (P for trend = 0.009) but not among females (P for trend = 0.96). In a multivariable logistic regression analysis adjusting for potential confounding factors, such as age, smoking and drinking habits, economic status, caloric intake, and physical activity, the odds ratio (OR) for diabetes was significantly lower in the highest UME quartile group compared with the lowest quartile group among males (OR, 0.35; 95% CI, 0.17-0.70; P = 0.003) but not females (OR, 0.94; 95% CI, 0.45-1.95; P = 0.87). Consistent results were observed in the analysis after adjusting for clinical parameters or using continuous UME data.

CONCLUSIONS

Melatonin secretion was significantly and inversely associated with diabetes in males but not in females. This association was independent of several important confounding factors.

摘要

目的

有报道称褪黑素可保护胰岛并降低胰岛素抵抗,因此,它可能有助于预防糖尿病。流行病学数据表明,女性褪黑素分泌较低与糖尿病发病率较高相关。但这种关联在普通人群中尚不清楚。我们评估了褪黑素分泌与包括男女两性在内的普通人群中糖尿病之间的关系。

设计

横断面研究。

参与者

共纳入 1096 名社区居住的老年男性(n=519)和女性(n=577)(平均年龄 71.8 岁)。

测量

测量整夜尿 6-硫酸褪黑素排泄量(UME)和糖尿病患病率。

结果

中位 UME 为 6.7μg(四分位间距 4.0-10.5);男性糖尿病患病率为 17.5%,女性为 10.7%。在男性中,随着 UME 四分位组的升高,糖尿病患病率呈下降趋势(趋势 P=0.009),但在女性中无此趋势(趋势 P=0.96)。在校正潜在混杂因素(如年龄、吸烟和饮酒习惯、经济状况、热量摄入和体力活动)的多变量 logistic 回归分析中,与最低 UME 四分位组相比,最高 UME 四分位组男性患糖尿病的比值比(OR)显著降低(OR,0.35;95%CI,0.17-0.70;P=0.003),但女性中无此相关性(OR,0.94;95%CI,0.45-1.95;P=0.87)。在校正临床参数或使用连续 UME 数据后,分析结果仍一致。

结论

褪黑素分泌与男性糖尿病显著负相关,但与女性无关。这种关联独立于一些重要的混杂因素。

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