The Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Medical/Steno Research Laboratory, Aarhus University, Aarhus, Denmark.
Clin Endocrinol (Oxf). 2021 Nov;95(5):691-701. doi: 10.1111/cen.14576. Epub 2021 Aug 18.
Melatonin is increasingly used as a pharmacological sleep aid but it is also emerging as a regulator of glucose homoeostasis. Yet, previous research has been ambiguous with reports of both positive and negative effects of melatonin on glucose metabolism.
To assess the effect of daily treatment with melatonin on fasting glucose, insulin, insulin sensitivity and haemoglobin A1c (HbA1c) levels.
MEDLINE, EMBASE, CENTRAL, clinicaltrials.gov and clinicaltrialsregister.eu were systematically searched.
ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: All randomized, placebo-controlled studies with melatonin treatment were assessed. We included studies with daily melatonin treatment (≥2 weeks) of healthy adults or patients with metabolic diseases.
Hedges' g differences were calculated for the metabolic parameters of the included studies, heterogeneity was assessed with χ and I tests and meta-analyses were performed with the random-effects model.
Long-term treatment with melatonin did not change fasting glucose significantly compared with placebo (g: -0.07 [-0.22 to 0.08], n = 603) but it reduced fasting insulin levels slightly (g: -0.27 [-0.50 to -0.04], n = 278) and trended towards reduced insulin resistance (HOMA-IR) (g: -0.20 [-0.44 to 0.03], n = 278). HbA1c levels were largely unaffected by melatonin treatment compared with placebo (g: 0.14 [-0.19 to 0.46], n = 142).
With the available literature, melatonin seems to be a glucose-metabolic safe sleep aid in patients with metabolic diseases and in healthy adults. It may even have beneficial glucose-metabolic effects as fasting insulin levels were reduced in this meta-analysis, but the confidence intervals of the meta-analyses are wide, underscoring the need for further research within this field.
褪黑素作为一种药理学助眠药物越来越受到关注，但它也正在成为血糖稳态调节因子。然而，先前的研究结果并不明确，有报道称褪黑素对葡萄糖代谢既有积极影响，也有消极影响。
评估每日使用褪黑素治疗对空腹血糖、胰岛素、胰岛素敏感性和糖化血红蛋白（HbA1c）水平的影响。
系统检索了 MEDLINE、EMBASE、CENTRAL、clinicaltrials.gov 和 clinicaltrialsregister.eu 数据库。
入选标准、参与者和干预措施：评估了所有使用褪黑素治疗的随机、安慰剂对照研究。我们纳入了对健康成年人或代谢性疾病患者进行每日褪黑素治疗（≥2 周）的研究。
计算纳入研究的代谢参数的 Hedge's g 差异，使用 χ2 和 I2 检验评估异质性，并使用随机效应模型进行荟萃分析。
与安慰剂相比，长期褪黑素治疗并未显著改变空腹血糖（g：-0.07 [-0.22 至 0.08]，n=603），但略微降低了空腹胰岛素水平（g：-0.27 [-0.50 至 -0.04]，n=278），且胰岛素抵抗（HOMA-IR）有降低趋势（g：-0.20 [-0.44 至 0.03]，n=278）。与安慰剂相比，褪黑素治疗对 HbA1c 水平的影响不大（g：0.14 [-0.19 至 0.46]，n=142）。
根据现有文献，褪黑素似乎是代谢性疾病患者和健康成年人安全的助眠药物，对血糖代谢没有不良影响。在本荟萃分析中，空腹胰岛素水平降低，这表明褪黑素可能具有有益的血糖代谢作用，但荟萃分析的置信区间较宽，突出了该领域进一步研究的必要性。
