Universidad de Granada, Departamento de Medicina Preventiva y Salud Pública, Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
J Urol. 2022 Mar;207(3):565-572. doi: 10.1097/JU.0000000000002294. Epub 2021 Oct 25.
We analyzed the association between salivary melatonin rhythm and prostate cancer (PCa).
A total of 40 PCa cases and 41 controls from the CAPLIFE study were analyzed to determine the salivary melatonin rhythm through 6 saliva samples. Amplitude (maximum melatonin peak) was categorized as low or high using the cutoff point median of the controls. Acrophase (time of maximum melatonin peak) was classified as early or late using the same criteria. In addition, the following data were collected: characteristics related to sleep habits, and clinical and sociodemographic information. Melatonin rhythms were represented for cases and controls and analyzed according to urinary symptoms, tumor aggressiveness and tumor extension. Variations in melatonin levels were estimated using generalized estimating equations on the ln-transformed values. To estimate the association between amplitude, acrophase and PCa, adjusted odds ratio (aOR) and 95% CI were calculated using logistic regression models.
The mean age was 67.0 years (SD 7.3) for cases and 67.5 (SD 5.5) for controls. Melatonin levels were always lower in PCa cases than in controls. On average, melatonin levels in cases were -64.0% (95% CI -73.4, -51.4) than controls. PCa cases had lower amplitude, 26.0 pg/ml (SD 27.8) vs 46.3 pg/ml (SD 28.2; p <0.001). A high amplitude was associated with a decreased risk of PCa, aOR=0.31 (95% CI 0.11, 0.86), while a late acrophase could be increased risk of PCa, aOR=2.36 (95% CI 0.88, 6.27).
Patients with PCa always had lower melatonin levels than men without PCa, independent of urinary symptomatology or extension and aggressiveness of the tumor.
我们分析了唾液褪黑素节律与前列腺癌（PCa）之间的关系。
对 CAPLIFE 研究中的 40 例 PCa 病例和 41 例对照进行分析，通过 6 个唾液样本确定唾液褪黑素节律。使用对照中位数作为截断值，将振幅（最大褪黑素峰值）分为低或高。使用相同标准，将时相（最大褪黑素峰值时间）分类为早或晚。此外，还收集了与睡眠习惯相关的特征以及临床和社会人口学信息。根据尿症状、肿瘤侵袭性和肿瘤扩散情况，代表病例和对照的褪黑素节律并进行分析。使用广义估计方程对数变换值估计褪黑素水平的变化。使用逻辑回归模型计算调整后的优势比（aOR）和 95%CI 来估计振幅、时相和 PCa 之间的关联。
病例的平均年龄为 67.0 岁（SD 7.3），对照组为 67.5 岁（SD 5.5）。PCa 病例的褪黑素水平总是低于对照组。平均而言，病例组的褪黑素水平比对照组低-64.0%（95%CI -73.4，-51.4）。PCa 病例的振幅较低，为 26.0pg/ml（SD 27.8）vs 46.3pg/ml（SD 28.2；p<0.001）。高振幅与 PCa 风险降低相关，aOR=0.31（95%CI 0.11，0.86），而晚时相可能增加 PCa 的风险，aOR=2.36（95%CI 0.88，6.27）。
无论是否存在尿症状或肿瘤的扩散和侵袭性，患有 PCa 的患者的褪黑素水平总是低于没有 PCa 的男性。
