Kimland Elin E, Dahlén Elin, Martikainen Jari, Célind Jimmy, Kindblom Jenny M
Swedish Medical Products Agency, 751 03 Uppsala, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83 Stockholm, Sweden.
Pharmaceuticals (Basel). 2023 Mar 6;16(3):396. doi: 10.3390/ph16030396.
The prescription of melatonin to children and adolescents has increased dramatically in Sweden and internationally during the last ten years. In the present study we aimed to evaluate the prescribed melatonin dose in relation to body weight and age in children. The population-based BMI Epidemiology Study Gothenburg cohort has weight available from school health care records, and information on melatonin prescription through linkage with high-quality national registers. We included prescriptions of melatonin to individuals below 18 years of age where a weight measurement not earlier than three months before, or later than six months after the dispensing date, was available (n = 1554). Similar maximum doses were prescribed to individuals with overweight orobesity as to individuals with normal weight, and to individuals below and above 9 years of age. Age and weight only explained a marginal part of the variance in maximum dose, but were inversely associated and explained a substantial part of the variance in maximum dose per kg. As a result, individuals overweight or with obesity, or age above 9 years, received lower maximum dose per kg of body weight, compared with individuals with normal weight or below 9 years of age. Thus, the prescribed melatonin dose to individuals under 18 years of age is not primarily informed by body weight or age, resulting in substantial differences in prescribed dose per kg of body weight across BMI and age distribution.
在过去十年中，瑞典及国际上给儿童和青少年开褪黑素的处方量急剧增加。在本研究中，我们旨在评估儿童褪黑素处方剂量与体重和年龄的关系。基于人群的哥德堡队列BMI流行病学研究可从学校医疗记录中获取体重信息，并通过与高质量的国家登记册联动获取褪黑素处方信息。我们纳入了给18岁以下个体开褪黑素的处方，这些个体在配药日期前不早于三个月或后不晚于六个月有体重测量值（n = 1554）。超重或肥胖个体与正常体重个体、9岁以下和9岁以上个体的最大处方剂量相似。年龄和体重仅解释了最大剂量方差的一小部分，但它们呈负相关，并解释了每千克最大剂量方差的很大一部分。结果，与正常体重个体或9岁以下个体相比，超重或肥胖个体或9岁以上个体每千克体重的最大剂量较低。因此，给18岁以下个体开的褪黑素剂量主要不是由体重或年龄决定的，这导致不同BMI和年龄分布的个体每千克体重的处方剂量存在很大差异。
