Melatonin and female hormone secretion in postmenopausal overweight women

Significance of Melatonin in the Regulation of Circadian Rhythms and Disease Management

Melatonin, the 'hormone of darkness' is a neuronal hormone secreted by the pineal gland and other extra pineal sites. Responsible for the circadian rhythm and seasonal behaviour of vertebrates and mammals, melatonin is responsible for regulating various physiological conditions and the maintenance of sleep, body weight and the neuronal activities of the ocular sites. With its unique amphiphilic structure, melatonin can cross the cellular barriers and elucidate its activities in the subcellular components, including mitochondria. Melatonin is a potential scavenger of oxygen and nitrogen-reactive species and can directly obliterate the ROS and RNS by a receptor-independent mechanism. It can also regulate the pro- and anti-inflammatory cytokines in various pathological conditions and exhibit therapeutic activities against neurodegenerative, psychiatric disorders and cancer. Melatonin is also found to show its effects on major organs, particularly the brain, liver and heart, and also imparts a role in the modulation of the immune system. Thus, melatonin is a multifaceted candidate with immense therapeutic potential and is still considered an effective supplement on various therapies. This is primarily due to rectification of aberrant circadian rhythm by improvement of sleep quality associated with risk development of neurodegenerative, cognitive, cardiovascular and other metabolic disorders, thereby enhancing the quality of life.

Melatonin and its Relationships with Diabetes and Obesity: A Literature Review

BACKGROUND

Obesity is an important clinical entity, causing many public health issues. Around two billion people in the world are overweight and obese. Almost 40% of American adults are obese and Brazil has about 18 million obese people. Nowadays, 415 million people have diabetes, around 1 in every 11 adults. These numbers will rise to 650 million people within 20 years. Melatonin shows a positive profile on the regulation of the metabolism of the human body.

OBJECTIVE

This study aimed to carry out a broad narrative review of the metabolic profile and associations between melatonin, diabetes and obesity.

METHODS

Article reviews, systematic reviews, prospective studies, retrospective studies, randomized, double-blind, and placebo-controlled trials in humans recently published were selected and analyzed. A total of 368 articles were collated and submitted to the eligibility analysis. Subsequently, 215 studies were selected to compose the content part of the paper, and 153 studies composed the narrative review.

RESULTS

Studies suggest a possible role of melatonin in metabolic diseases such as obesity, T2DM and metabolic syndrome. Intervention studies using this hormone in metabolic diseases are still unclear regarding the possible benefit of it. There is so far no consensus about the possible role of melatonin as an adjuvant in the treatment of metabolic diseases. More studies are necessary to define possible risks and benefits of melatonin as a therapeutic agent.

The value of melatonin supplementation in postmenopausal women with Helicobacter pylori-associated dyspepsia

BACKGROUND

Dyspeptic syndrome is particularly common in postmenopausal women in the form of epigastric pain. The aim of the study was to assess the role of melatonin in chronic dyspepsia in this group of women, and examine the role of Helicobacter infection.

METHODS

The study comprised 152 subjects including 30 healthy women (Group I), 60 women with asymptomatic H.pylori infection (Group II), and 64 women with H. pylori infection with chronic dyspepsia (Group III). Endoscopic examination was performed, as well as histological assessment of gastric end duodenal mucosa, urease breath test (UBT-13C), and immunoenzymatic assessment of serum 17-β-estradiol, follicle stimulating hormone and melatonin, and urinary 6-sulfatoxymelatonin. In Group III, 14-day antibacterial treatment was introduced with pantoprazole, amoxicillin and levofloxacin followed a six-month treatment with placebo in 32 women (Group IIIa), and melatonin 1 mg/morning and 3 mg/at bedtime in the other 32 women (Group IIIb).

RESULTS

No significant differences were found between serum level of female hormone. Serum melatonin levels were similar between Group I (12.5 ± 2.72 pg/ml) and Group II (10.5 ± 3.73 pg/ml; p > 0,05). The level was significantly lower in Group III (5.72 ± 1.42 pg/ml; p < 0.001). Eradication of H.pylori was obtained in 75.0% women in Group IIIa, and in 84.3% in Group IIIb (p > 0.05). After six months, dyspeptic symptoms resolved in 43.7% patients in Group IIIa and 84.3% in Group IIIb (p < 0.001).

CONCLUSION

Melatonin supplementation is useful in treating H. pylori-associated dyspepsia, particularly in postmenopausal women with lower levels of this hormone.

TRIAL REGISTRATION

NCT04352062, date of registration: 15.04.2020.

Melatonin supplementation in the management of obesity and obesity-associated disorders: A review of physiological mechanisms and clinical applications

Despite the evolving advances in clinical approaches to obesity and its inherent comorbidities, the therapeutic challenge persists. Among several pharmacological tools already investigated, recent studies suggest that melatonin supplementation could be an efficient therapeutic approach in the context of obesity. In the present review, we have amalgamated the evidence so far available on physiological effects of melatonin supplementation in obesity therapies, addressing its effects upon neuroendocrine systems, cardiometabolic biomarkers and body composition. Most studies herein appraised employed melatonin supplementation at dosages ranging from 1 to 20 mg/day, and most studies followed up participants for periods from 3 weeks to 12 months. Overall, it was observed that melatonin plays an important role in glycaemic homeostasis, in addition to modulation of white adipose tissue activity and lipid metabolism, and mitochondrial activity. Additionally, melatonin increases brown adipose tissue volume and activity, and its antioxidant and anti-inflammatory properties have also been demonstrated. There appears to be a role for melatonin in adiposity reduction; however, several questions remain unanswered, for example melatonin baseline levels in obesity, and whether any seeming hypomelatonaemia or melatonin irresponsiveness could be clarifying factors. Supplementation dosage studies and more thorough clinical trials are needed to ascertain not only the relevance of such findings but also the efficacy of melatonin supplementation.

Acute metabolic responses after continuous or interval exercise in post-menopausal women with overweight or obesity

This pilot study compared the effects of acute high-intensity intermittent exercise (HIIE) and moderate-intensity continuous exercise (MICE) on post-exercise VO₂ , fat utilization, and 24-hours energy balance to understand the mechanism of higher fat mass reduction observed after high-intensity interval training in post-menopausal women with overweight/obesity. 12 fasted women (59.5 ± 5.8 years; BMI: 28.9 ± 3.9 kg·m^-2 ) completed three isoenergetic cycling exercise sessions in a counterbalanced, randomized order: (a) MICE [35 minutes at 60%-65% of peak heart rate, HR_max ], (b) HIIE 1 [60 × (8-s cycling-12-s recovery) at 80%-90% of HR_max ], and (c) HIIE 2 [10 × 1min at 80%-90% of HR_max  - 1-min recovery]. Then, VO₂ and fat utilization measured at rest and during the 2 hours post-exercise, enjoyment, perceived exertion, and appetite recorded during the session and energy intake (EI) and energy expenditure (EE) assessed over the next 24 hours were compared for the three modalities. Overall, fat utilization increased after exercise. No modality effect or time-modality interaction was observed concerning VO₂ and fat oxidation rate during the 2 hours post-exercise. The two exercise modalities did not induce specific EI and EE adaptations, but perceived appetite scores at 1 hour post-exercise were lower after HIIE 1 and HIIE 2 than MICE. Perceived exertion was higher during HIIE 1 and HIIE 2 than MICE, but enjoyment did not differ among modalities. The acute HIIE responses did not allow explaining the greater fat mass loss observed after regular high-intensity interval training in post-menopausal women with overweight/obesity. More studies are needed to understand the mechanisms involved in such adaptations.

Crosstalk Among Circadian Rhythm, Obesity and Allergy

The circadian clock system works not only as a cellular time-keeper but also as a coordinator for almost all physiological functions essential to maintaining human health. Therefore, disruptions or malfunctions of this system can cause many diseases and pre-symptomatic conditions. Indeed, previous studies have indicated that disrupted clock gene expression rhythm is closely related to obesity, and that allergic diseases can be regulated by controlling peripheral clocks in organs and tissues. Moreover, recent studies have found that obesity can lead to immune disorders. Accordingly, in this review, we assess the connection between obesity and allergy from the point of view of the circadian clock system anew and summarize the relationships among the circadian clock system, obesity, and allergy.

Circulating neurohormone imbalances in canine sudden acquired retinal degeneration syndrome and canine pituitary-dependent hypercortisolism

BACKGROUND

Sudden acquired retinal degeneration syndrome (SARDS) has clinical similarity to pituitary-dependent hypercortisolism (PDH) in dogs. Some studies have identified a greater frequency of SARDS in seasons with reduced daylight hours. Neurohormone imbalances contribute to retinal lesions in other species, warranting further study in dogs with SARDS.

HYPOTHESIS

Dysregulation of circulating melatonin concentration is present in dogs with SARDS but not in dogs with PDH.

ANIMALS

Fifteen client-owned dogs with spontaneous SARDS (median time of vision loss 18 days), 14 normal dogs, and 13 dogs with confirmed PDH.

PROCEDURES

Prospective case-control study. ELISA on samples (obtained in the morning) for measurement of plasma melatonin and dopamine, serum serotonin, urine 6-sulfatoxymelatonin (MT6s), and creatinine. Statistical analysis was performed using 1-way ANOVA, Spearman correlation and receiver operator characteristic area under the curve analysis.

RESULTS

There were no significant differences in circulating melatonin, serotonin or dopamine concentrations between the 3 groups, although the study was underpowered for detection of significant differences in serum serotonin. Urine MT6s:creatinine ratio was significantly higher in dogs with PDH (4.08 ± 2.15 urine [MT6s] ng/mL per mg of urine creatinine) compared with dogs with SARDS (2.37 ± .51, P < .01), but not compared with normal dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

We have identified neurohormone differences between dogs with SARDS and PDH.

Effect of oophorosalpingo-hysterectomy on serum antioxidant enzymes in female dogs

There are few studies evaluating the oxidant-antioxidant status after oophorosalpingohysterectomy (OSH) in female dogs. Here we determined the effect of OSH on antioxidant enzymes in serum, and quantified morphological changes in subcutaneous adipocytes. Lateral OSH was performed in 12 female dogs. The concentration of 17β-estradiol (17β-E₂), the activities of extracellular superoxide dismutase (SOD-ec), glutathione peroxidase (GPx), glutathione-S-transferase (GST) and glutathione reductase (GR) were determined. Glutathione (GSH), glutathione disulfide (GSSG), lipid peroxidation (LPO), total antioxidant capacity (TAC), carbonylation and vitamin C were measured in serum. Subcutaneous adipose tissue was obtained to determine morphological changes and cell number, under basal conditions and six months after OSH. The SOD-ec, GPx and GST activities increased significantly (p ≤ 0.05), LPO, carbonylation and GSSG also increased. GSH and vitamin C decreased (p = 0.03). 17β-E₂ tended to decrease six months after OSH. Hypertrophy of subcutaneous adipocytes was observed after OSH from the first month and was accentuated after six months (p = 0.001). The results suggest that 17β-E₂ decreases after OSH and alters the antioxidant enzyme activities in serum thus, redox balance is altered. These changes are associated with an increase in body weight and hypertrophy of subcutaneous adipose tissue.

Melatonin as a Hormone: New Physiological and Clinical Insights

Melatonin is a ubiquitous molecule present in almost every live being from bacteria to humans. In vertebrates, besides being produced in peripheral tissues and acting as an autocrine and paracrine signal, melatonin is centrally synthetized by a neuroendocrine organ, the pineal gland. Independently of the considered species, pineal hormone melatonin is always produced during the night and its production and secretory episode duration are directly dependent on the length of the night. As its production is tightly linked to the light/dark cycle, melatonin main hormonal systemic integrative action is to coordinate behavioral and physiological adaptations to the environmental geophysical day and season. The circadian signal is dependent on its daily production regularity, on the contrast between day and night concentrations, and on specially developed ways of action. During its daily secretory episode, melatonin coordinates the night adaptive physiology through immediate effects and primes the day adaptive responses through prospective effects that will only appear at daytime, when melatonin is absent. Similarly, the annual history of the daily melatonin secretory episode duration primes the central nervous/endocrine system to the seasons to come. Remarkably, maternal melatonin programs the fetuses' behavior and physiology to cope with the environmental light/dark cycle and season after birth. These unique ways of action turn melatonin into a biological time-domain-acting molecule. The present review focuses on the above considerations, proposes a putative classification of clinical melatonin dysfunctions, and discusses general guidelines to the therapeutic use of melatonin.

Effects of Menopause on Appetite and the Gastrointestinal System

This article includes a brief literature review and case example to explore the effects of menopause on hormones that influence appetite and the function of the gastrointestinal system. The importance of exercise and diet are discussed, as are implications for nursing practice.

INSOMNIA AND CIRCADIAN RHYTHMS OF MELATONIN IN MENOPAUSAL WOMEN

The aim of the review is to analyze literature data about sleep homeostasis and the role of the one of circadian system key elements – melatonin – in the regulation of the sleep-wake cycle in women in menopause. It was shown that the prevalence and structure of sleep disorders depends on the menopausal phase. It was revealed that the melatonin content in the body, determined in various biological media (blood, saliva, urine), depends on age, sex, race, and chronotype. It was shown that morning melatonin can be used as a biological marker for determining the chronotype. Most studies indicated a decrease in melatonin level with aging. Moreover, women have lower melatonin level than men. In case of insomnia, lower melatonin level was found, although the results of the studies are ambiguous. The shift in the peak of hormone secretion in the early morning hours was described in menopausal women. Also, the dependence of melatonin circadian rhythm on the menopausal phase was revealed, which determines different approaches to insomnia therapy. We revealed the association of melatonin secretion circadian rhythms with Clock 3111T/C gene polymorphism in Caucasian patients with insomnia, which allows considering 3111T allele as risky in the formation of melatonin circadian rhythm disturbances in these patients.

Melatonin promotes osteoblast differentiation by regulating Osterix protein stability and expression

Although the biological role of melatonin in osteogenic differentiation has been suggested, the mechanism of osteoblast differentiation remains unclear. Thus, the present study investigated the underlying molecular mechanisms based on osteoblast-specific transcription factors. We found that melatonin enhanced BMP-4-induced osteogenic differentiation and increased the expression of osteogenic markers, especially Osterix, which is an essential transcription factor for the differentiation of preosteoblasts into mature osteoblasts in the late stage of osteoblast differentiation. Melatonin treatment increased the expression of Osterix during osteoblast differentiation and stabilized its expression by the inhibition of ubiquitin-proteasome-mediated degradation of Osterix, leading to up-regulated Osterix transcriptional activity on the osteogenic promoter and promoting alkaline phosphatase activity and bone mineralization. Furthermore, treatment with protein kinase A (PKA) inhibitor H89 and protein kinase C (PKC) inhibitor Go6976 blocked the melatonin-induced transcriptional activity and phosphorylation of Osterix, indicating that melatonin regulates Osterix expression via the PKA and PKC signaling pathways. Overall, these findings suggest that melatonin directly regulates the late stage of osteoblast differentiation by enhancing Osterix expression; this provides further evidence of melatonin as a potent agent for treating osteoporosis.

Melatonin levels in follicular fluid as markers for IVF outcomes and predicting ovarian reserve

Good-quality oocytes are critical for the success of in vitro fertilization (IVF), but, to date, there is no marker of ovarian reserve available that can accurately predict oocyte quality. Melatonin exerts its antioxidant actions as a strong radical scavenger that might affect oocyte quality directly as it is the most potent antioxidant in follicular fluid. To investigate the precise role of endogenous melatonin in IVF outcomes, we recruited 61 women undergoing treatment cycles of IVF or intracytoplasmic sperm injection (ICSI) procedures and classified them into three groups according to their response to ovarian stimulation. Follicular fluid was collected to assess melatonin levels using a direct RIA method. We found good correlations between melatonin levels in follicular fluid with age, anti-Müllerian hormone (AMH) and baseline follicle-stimulating hormone (bFSH), all of which have been used to predict ovarian reserve. Furthermore, as melatonin levels correlated to IVF outcomes, higher numbers of oocytes were collected from patients with higher melatonin levels and consequently the number of oocytes fertilized, zygotes cleaved, top quality embryos on D3, blastocysts obtained and embryos suitable for transplantation was higher. The blastocyst rate increased in concert with the melatonin levels across the gradient between the poor response group and the high response group. These results demonstrated that the melatonin levels in follicular fluid is associated with both the quantity and quality of oocytes and can predict IVF outcomes as well making them highly relevant biochemical markers of ovarian reserve.

Melatonin's role as a co-adjuvant treatment in colonic diseases: A review

Melatonin is produced in the pineal gland as well as many other organs, including the enterochromaffin cells of the digestive mucosa. Melatonin is a powerful antioxidant that resists oxidative stress due to its capacity to directly scavenge reactive species, to modulate the antioxidant defense system by increasing the activities of antioxidant enzymes, and to stimulate the innate immune response through its direct and indirect actions. In addition, the dysregulation of the circadian system is observed to be related with alterations in colonic motility and cell disruptions due to the modifications of clock genes expression. In the gastrointestinal tract, the activities of melatonin are mediated by melatonin receptors (MT2), serotonin (5-HT), and cholecystokinin B (CCK2) receptors and via receptor-independent processes. The levels of melatonin in the gastrointestinal tract exceed by 10-100 times the blood concentrations. Also, there is an estimated 400 times more melatonin in the gut than in the pineal gland. Gut melatonin secretion is suggested to be influenced by the food intake. Low dose melatonin treatment accelerates intestinal transit time whereas high doses may decrease gut motility. Melatonin has been studied as a co-adjuvant treatment in several gastrointestinal diseases including irritable bowel syndrome (IBS), constipation-predominant IBS (IBS-C), diarrhea-predominant IBS (IBS-D), Crohn's disease, ulcerative colitis, and necrotizing enterocolitis. The purpose of this review is to provide information regarding the potential benefits of melatonin as a co-adjuvant treatment in gastrointestinal diseases, especially IBS, Crohn's disease, ulcerative colitis, and necrotizing enterocolitis.

Reduced fat mass and increased lean mass in response to 1 year of melatonin treatment in postmenopausal women: A randomized placebo-controlled trial

OBJECTIVE

Apart from regulating the circadian rhythm, melatonin exerts a variety of actions in the living organism. Among these functions, melatonin is believed to have a positive effect on body weight and energy metabolism. So far, the evidence for this relies mainly on animal models. In this study, we aimed to determine the effects of melatonin on body composition, lipid and glucose metabolism in humans.

DESIGN/METHODS

In a double-blind, placebo-controlled study, we randomized 81 postmenopausal women to 1 year of treatment with melatonin (1 or 3 mg nightly) or placebo. Body composition was measured by DXA. Measures were obtained at baseline and after 1 year of treatment along with leptin, adiponectin and insulin. Markers of glucose homeostasis were measured at the end of the study.

RESULTS

In response to treatment, fat mass decreased in the melatonin group by 6·9% (95% CI: 1·4%; 12·4%, P = 0·02) compared to placebo. A borderline significant increase in lean mass of 5·2% was found in the melatonin group compared to placebo (3·3%, (IQR:-1·7; 6·2) vs -1·9%, (IQR: -5·7; 5·8), P = 0·08). After adjusting for BMI, lean mass increased by 2·6% (95% CI: 0·1; 5·0, P = 0·04) in the melatonin group. Changes in body weight and BMI did not differ between groups. Adiponectin increased borderline significantly by 21% in the melatonin group compared to placebo (P = 0·08). No significant changes were observed for leptin, insulin or markers of glucose homeostasis.

CONCLUSION

Our results suggest a possibly beneficial effect of melatonin on body composition and lipid metabolism as 1 year of treatment reduces fat mass, increases lean mass and is associated with a trend towards an increase in adiponectin.