Evans Adam T, Vanden Brink Heidi, Lim Jessica S, Jarrett Brittany Y, Lin Annie W, Lujan Marla E, Hoeger Kathleen
Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14620, USA.
Department of Nutrition, Texas A&M University, College Station, TX 77843, USA.
Biomedicines. 2023 Oct 12;11(10):2763. doi: 10.3390/biomedicines11102763.
Circulating melatonin is elevated in women with polycystic ovary syndrome (PCOS); whether circadian disruptions coincide with sleep disturbances in women with PCOS or their symptom severity is unclear. The objective of this observational pilot study was to determine whether altered patterns of melatonin excretion are associated with reduced sleep quality in women with versus without PCOS. Participants underwent a clinical assessment, transvaginal ultrasound, and reproductive hormone testing. Morning and evening urine samples were assayed for urinary 6-sulfatoxymelatonin (MEL) as a proxy for melatonin production. The night (morning MEL)-to-day (evening MEL) ratio, or N:D ratio, was determined to approximate the rhythm of MEL production. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and wrist actigraphy. No differences were detected in overnight MEL, daytime MEL, or the N:D ratio in participants with PCOS versus controls. The PCOS group experienced reduced weekend sleep efficiency vs. controls (81% vs. 88% < 0.05). The number of follicles per ovary (FNPO) was positively associated with overnight MEL (r = 0.359, < 0.05). Weekend sleep time and overnight MEL concentrations were dependent on PCOS status. Therefore, diagnostic features of PCOS were associated with MEL production and sleep disturbances, suggesting that women with a more severe clinical presentation of PCOS may be more likely to experience altered MEL production or sleep disturbances.
多囊卵巢综合征（PCOS）女性的循环褪黑素水平升高；目前尚不清楚PCOS女性的昼夜节律紊乱是否与睡眠障碍及其症状严重程度一致。这项观察性试点研究的目的是确定褪黑素排泄模式的改变是否与有无PCOS的女性睡眠质量下降有关。参与者接受了临床评估、经阴道超声检查和生殖激素检测。检测晨尿和晚尿样本中的尿6-硫酸氧褪黑素（MEL），作为褪黑素分泌的替代指标。通过计算夜间（晨尿MEL）与白天（晚尿MEL）的比值，即N:D比值，来近似褪黑素分泌的节律。使用匹兹堡睡眠质量指数（PSQI）和手腕活动记录仪评估睡眠质量和时长。PCOS患者与对照组在夜间MEL、白天MEL或N:D比值方面未检测到差异。与对照组相比，PCOS组周末的睡眠效率较低（81%对88%，<0.05）。每个卵巢的卵泡数量（FNPO）与夜间MEL呈正相关（r = 0.359，<0.05）。周末睡眠时间和夜间MEL浓度取决于PCOS状态。因此，PCOS的诊断特征与MEL分泌和睡眠障碍有关，这表明PCOS临床表现更严重的女性可能更有可能出现MEL分泌改变或睡眠障碍。
