Li Linyi, Zhao Zhenxiang, Ma Jianjun, Zheng Jinhua, Huang Shen, Hu Shiyu, Gu Qi, Chen Siyuan
Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.
Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Henan University, Zhengzhou, China.
Front Neurosci. 2020 May 19;14:505. doi: 10.3389/fnins.2020.00505. eCollection 2020.
Melatonin is the major hormone produced and secreted at night by the pineal gland into the cerebrospinal fluid (CSF) and circulation. The relationship between plasma melatonin levels and Parkinson's disease is not clear. The aim of the current study was to assess plasma melatonin levels in Parkinson's disease (PD) patients and to analysis the relationship between plasma melatonin levels and non-motor symptoms.
In this cross-sectional study, we evaluated 61 patients with idiopathic PD [males = 30 (49.2%), average age 62.4 years (range: 46-73 years)] and a total of 58 healthy volunteers [males = 30 (51.7%), average age 64.3 years (range: 45-70 years)] who participated in the study. Plasma melatonin levels were measured using an enzyme-linked immunosorbent assay. The severity of disease in PD patients was scored by the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr Staging scale. The quality of life in PD patients was assessed by the 39-item Parkinson's Disease Questionnaire. The non-motor symptoms were assessed by the 14-item Hamilton Anxiety Rating Scale, the 24-item Hamilton Depression Rating Scale, the Parkinson Disease Sleep Scale, the Epworth Sleepiness Scale and the Non-Motor Symptoms Scale for PD.
Compared with the healthy controls, the plasma melatonin levels were significantly higher in PD patients (12.82 ± 4.85 vs. 19.40 ± 4.23, 0.001). Plasma melatonin levels were significantly associated with the levodopa equivalent daily dose (0.262, 0.05, = 61). Higher plasma melatonin concentrations were detected in the negative cardiovascular symptom group than in the cardiovascular symptom group (20.13 ± 3.74 vs. 16.93 ± 3.74, 0.05). Higher plasma melatonin concentrations were detected in the non-sleep-disorders group than in the sleep disorders group (22.12 ± 5.93 vs. 18.86 ± 3.66, < 0.05). In addition, the plasma melatonin concentration was higher in the group without gastrointestinal dysfunction than in the gastrointestinal dysfunction group (21.71 ± 4.44 vs. 18.35 ± 3.74, < 0.05).
This study revealed that the plasma melatonin levels in PD patients were significantly higher than those in healthy controls. Non-motor symptoms that were significantly negatively correlated with plasma melatonin levels were cardiovascular symptoms, sleep disorders, and gastrointestinal dysfunction. Plasma melatonin levels have the closest relationship with sleep disorders. There was a correlation between plasma melatonin levels and sleep quality in patients with PD. The remaining non-motor symptoms were not related to plasma melatonin levels.
褪黑素是松果体在夜间产生并分泌到脑脊液（CSF）和循环系统中的主要激素。血浆褪黑素水平与帕金森病之间的关系尚不清楚。本研究的目的是评估帕金森病（PD）患者的血浆褪黑素水平，并分析血浆褪黑素水平与非运动症状之间的关系。
在这项横断面研究中，我们评估了61例特发性PD患者[男性30例（49.2%），平均年龄62.4岁（范围：46 - 73岁）]以及总共58名参与研究的健康志愿者[男性30例（51.7%），平均年龄64.3岁（范围：45 - 70岁）]。使用酶联免疫吸附测定法测量血浆褪黑素水平。PD患者的疾病严重程度通过统一帕金森病评定量表和霍恩及雅尔分期量表进行评分。PD患者的生活质量通过39项帕金森病问卷进行评估。非运动症状通过14项汉密尔顿焦虑评定量表、24项汉密尔顿抑郁评定量表、帕金森病睡眠量表、爱泼华嗜睡量表和PD非运动症状量表进行评估。
与健康对照组相比，PD患者的血浆褪黑素水平显著更高（12.82±4.85 vs. 19.40±4.23，P = 0.001）。血浆褪黑素水平与左旋多巴等效日剂量显著相关（r = 0.262，P = 0.05，n = 61）。在无心血管症状组中检测到的血浆褪黑素浓度高于心血管症状组（20.13±3.74 vs. 16.93±3.74，P = 0.05）。在非睡眠障碍组中检测到的血浆褪黑素浓度高于睡眠障碍组（22.12±5.93 vs. 18.86±3.66，P < 0.05）。此外，在无胃肠功能障碍组中的血浆褪黑素浓度高于胃肠功能障碍组（21.71±4.44 vs. 18.35±3.74，P < 0.05）。
本研究表明，PD患者的血浆褪黑素水平显著高于健康对照组。与血浆褪黑素水平显著负相关的非运动症状是心血管症状、睡眠障碍和胃肠功能障碍。血浆褪黑素水平与睡眠障碍关系最为密切。PD患者的血浆褪黑素水平与睡眠质量之间存在相关性。其余非运动症状与血浆褪黑素水平无关。
