Department of Clinical Nutrition and Gastroenterological Diagnostics of Medical University, Lodz, Poland.
BMC Womens Health. 2020 Nov 26;20(1):262. doi: 10.1186/s12905-020-01117-z.
Dyspeptic syndrome is particularly common in postmenopausal women in the form of epigastric pain. The aim of the study was to assess the role of melatonin in chronic dyspepsia in this group of women, and examine the role of Helicobacter infection.
The study comprised 152 subjects including 30 healthy women (Group I), 60 women with asymptomatic H.pylori infection (Group II), and 64 women with H. pylori infection with chronic dyspepsia (Group III). Endoscopic examination was performed, as well as histological assessment of gastric end duodenal mucosa, urease breath test (UBT-13C), and immunoenzymatic assessment of serum 17-β-estradiol, follicle stimulating hormone and melatonin, and urinary 6-sulfatoxymelatonin. In Group III, 14-day antibacterial treatment was introduced with pantoprazole, amoxicillin and levofloxacin followed a six-month treatment with placebo in 32 women (Group IIIa), and melatonin 1 mg/morning and 3 mg/at bedtime in the other 32 women (Group IIIb).
No significant differences were found between serum level of female hormone. Serum melatonin levels were similar between Group I (12.5 ± 2.72 pg/ml) and Group II (10.5 ± 3.73 pg/ml; p > 0,05). The level was significantly lower in Group III (5.72 ± 1.42 pg/ml; p < 0.001). Eradication of H.pylori was obtained in 75.0% women in Group IIIa, and in 84.3% in Group IIIb (p > 0.05). After six months, dyspeptic symptoms resolved in 43.7% patients in Group IIIa and 84.3% in Group IIIb (p < 0.001).
Melatonin supplementation is useful in treating H. pylori-associated dyspepsia, particularly in postmenopausal women with lower levels of this hormone.
NCT04352062, date of registration: 15.04.2020.
在上了年纪的女性中，以胃脘痛为主要表现的功能性消化不良较为常见。本研究旨在评估褪黑素在这一女性人群中的慢性消化不良中的作用，并探讨幽门螺杆菌感染的作用。
研究共纳入 152 例受试者，包括 30 例健康女性（I 组）、60 例无症状 H.pylori 感染女性（II 组）和 64 例 H.pylori 感染合并慢性消化不良女性（III 组）。进行内镜检查，胃十二指肠黏膜组织学评估，尿素酶呼气试验（UBT-13C），以及血清 17-β-雌二醇、卵泡刺激素和褪黑素、尿液 6-硫酸褪黑素的免疫酶分析。III 组采用泮托拉唑、阿莫西林和左氧氟沙星进行 14 天的抗菌治疗，然后 32 例女性（IIIa 组）接受 6 个月的安慰剂治疗，另 32 例女性（IIIb 组）接受褪黑素 1mg/晨起和 3mg/睡前治疗。
血清女性激素水平无显著差异。I 组（12.5±2.72pg/ml）和 II 组（10.5±3.73pg/ml；p>0.05）的血清褪黑素水平相似。而 III 组的水平明显更低（5.72±1.42pg/ml；p<0.001）。IIIa 组 75.0%的女性幽门螺杆菌被根除，IIIb 组为 84.3%（p>0.05）。6 个月后，IIIa 组 43.7%的患者消化不良症状缓解，IIIb 组为 84.3%（p<0.001）。
褪黑素补充治疗对 H.pylori 相关消化不良有效，特别是对这类激素水平较低的绝经后女性。
NCT04352062，注册日期：2020 年 4 月 15 日。
