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褪黑素补充治疗肥胖及其相关疾病:生理机制与临床应用综述。

Melatonin supplementation in the management of obesity and obesity-associated disorders: A review of physiological mechanisms and clinical applications.

机构信息

School of Medicine, University of Sao Paulo (USP), São Paulo, Brazil.

Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo, Brazil.

出版信息

Pharmacol Res. 2021 Jan;163:105254. doi: 10.1016/j.phrs.2020.105254. Epub 2020 Oct 17.

DOI:10.1016/j.phrs.2020.105254
PMID:33080320
Abstract

Despite the evolving advances in clinical approaches to obesity and its inherent comorbidities, the therapeutic challenge persists. Among several pharmacological tools already investigated, recent studies suggest that melatonin supplementation could be an efficient therapeutic approach in the context of obesity. In the present review, we have amalgamated the evidence so far available on physiological effects of melatonin supplementation in obesity therapies, addressing its effects upon neuroendocrine systems, cardiometabolic biomarkers and body composition. Most studies herein appraised employed melatonin supplementation at dosages ranging from 1 to 20 mg/day, and most studies followed up participants for periods from 3 weeks to 12 months. Overall, it was observed that melatonin plays an important role in glycaemic homeostasis, in addition to modulation of white adipose tissue activity and lipid metabolism, and mitochondrial activity. Additionally, melatonin increases brown adipose tissue volume and activity, and its antioxidant and anti-inflammatory properties have also been demonstrated. There appears to be a role for melatonin in adiposity reduction; however, several questions remain unanswered, for example melatonin baseline levels in obesity, and whether any seeming hypomelatonaemia or melatonin irresponsiveness could be clarifying factors. Supplementation dosage studies and more thorough clinical trials are needed to ascertain not only the relevance of such findings but also the efficacy of melatonin supplementation.

摘要

尽管临床治疗肥胖及其固有合并症的方法不断发展,但治疗挑战仍然存在。在已经研究过的几种药物工具中,最近的研究表明,褪黑素补充可能是肥胖症治疗的一种有效方法。在本综述中,我们综合了迄今为止关于褪黑素补充在肥胖症治疗中生理效应的证据,探讨了其对神经内分泌系统、心脏代谢生物标志物和身体成分的影响。本文评估的大多数研究采用的褪黑素补充剂量范围为 1 至 20 毫克/天,大多数研究的随访时间为 3 周至 12 个月。总的来说,观察到褪黑素在血糖稳态中发挥重要作用,此外还调节白色脂肪组织活性和脂质代谢以及线粒体活性。此外,褪黑素增加棕色脂肪组织的体积和活性,其抗氧化和抗炎特性也已得到证实。褪黑素似乎在减少肥胖方面发挥作用;然而,仍有几个问题尚未得到解答,例如肥胖症中的褪黑素基线水平,以及任何看似的低褪黑素血症或褪黑素不反应是否可以澄清这些问题。需要进行补充剂量研究和更全面的临床试验,以确定这些发现的相关性以及褪黑素补充的疗效。

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