Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité Universitätsmedizin Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
Center for Chronically Sick Children, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
Int J Obes (Lond). 2022 May;46(5):1051-1058. doi: 10.1038/s41366-022-01077-4. Epub 2022 Feb 9.
BACKGROUND/OBJECTIVES: Sleeping behavior and individual prospensity in sleep timing during a 24 h period, known as chronotypes, are underestimated factors, which may favor the development of obesity and metabolic diseases. Furthermore, melatonin is known to play an important role in circadian rhythm, but was also suggested to directly influence metabolism and bodyweight regulation. Since disturbed and shifted sleep rhythms have been observed in adolescents with obesity, this study aimed to investigate potential interactions between melatonin secretion, chronobiology, and metabolism. In addition, the influence of artificial light especially emitted by electronic devices on these parameters was of further interest.
SUBJECTS/METHODS: We performed a cross-sectional study including 149 adolescents (mean age 14.7 ± 2.1 years) with obesity. Metabolic blood parameters (e.g., cholesterol, triglycerides, uric acid, and insulin) were obtained from patients and correlated with nocturnal melatonin secretion. Melatonin secretion was determined by measuring 6-sulfatoxymelatonin (MT6s), the major metabolite of melatonin in the first-morning urine, and normalized to urinary creatinine levels to account for the urinary concentration. Chronobiologic parameters were further assessed using the Munich ChronoType Questionnaire.
Subjects with insulin resistance (n = 101) showed significantly lower nocturnal melatonin levels compared to those with unimpaired insulin secretion (p = 0.006). Furthermore, triglyceride (p = 0.012) and elevated uric acid levels (p = 0.029) showed significant associations with melatonin secretion. Patients with late chronotype showed a higher incidence of insulin resistance (p = 0.018). Moreover, late chronotype and social jetlag were associated with the time and duration of media consumption.
We identified an association of impaired energy metabolism and lower nocturnal melatonin secretion in addition to late chronotype and increased social jetlag (misalignment of biological and social clocks) in adolescents with obesity. This might point towards a crucial role of chronotype and melatonin secretion as risk factors for the development of pediatric and adolescent obesity.
背景/目的：在 24 小时周期内，睡眠行为和个体对睡眠时间的倾向性，即“生物钟”，是被低估的因素，可能有利于肥胖和代谢性疾病的发展。此外，褪黑素在昼夜节律中起着重要作用，但也被认为直接影响代谢和体重调节。由于肥胖青少年中观察到睡眠节律紊乱和移位，本研究旨在调查褪黑素分泌、生物钟和代谢之间的潜在相互作用。此外，人工光（特别是电子设备发出的光）对这些参数的影响也引起了进一步的关注。
受试者/方法：我们进行了一项横断面研究，纳入了 149 名肥胖青少年（平均年龄 14.7±2.1 岁）。从患者中获得代谢血液参数（如胆固醇、甘油三酯、尿酸和胰岛素），并与夜间褪黑素分泌相关联。通过测量晨尿中褪黑素的主要代谢产物 6-硫酸褪黑素（MT6s），并将其标准化为尿肌酐水平以反映尿浓度，来确定褪黑素分泌。使用慕尼黑生物钟问卷进一步评估生物钟参数。
胰岛素抵抗患者（n=101）的夜间褪黑素水平明显低于胰岛素分泌正常的患者（p=0.006）。此外，甘油三酯（p=0.012）和尿酸升高（p=0.029）与褪黑素分泌呈显著相关。晚型的患者胰岛素抵抗发生率更高（p=0.018）。此外，晚型和社交时差与媒体消费的时间和持续时间有关。
我们发现肥胖青少年中，能量代谢受损和夜间褪黑素分泌减少，以及晚型和社交时差（生物和社会时钟的不匹配）与胰岛素抵抗有关。这可能表明生物钟和褪黑素分泌作为小儿和青少年肥胖发生的危险因素的重要作用。
