Melatonin secretion and the incidence of type 2 diabetes.

Abstract

IMPORTANCE:

Loss-of-function mutations in the melatonin receptor are associated with insulin resistance and type 2 diabetes. Additionally, in a cross-sectional analysis of persons without diabetes, lower nocturnal melatonin secretion was associated with increased insulin resistance.

OBJECTIVE:

To study the association between melatonin secretion and the risk of developing type 2 diabetes.

DESIGN, SETTING, AND PARTICIPANTS:

Case-control study nested within the Nurses' Health Study cohort. Among participants without diabetes who provided urine and blood samples at baseline in 2000, we identified 370 women who developed type 2 diabetes from 2000-2012 and matched 370 controls using risk-set sampling.

MAIN OUTCOME MEASURES:

Associations between melatonin secretion at baseline and incidence of type 2 diabetes were evaluated with multivariable conditional logistic regression controlling for demographic characteristics, lifestyle habits, measures of sleep quality, and biomarkers of inflammation and endothelial dysfunction.

RESULTS:

The median urinary ratios of 6-sulfatoxymelatonin to creatinine were 28.2 ng/mg (5%-95% range, 5.5-84.2 ng/mg) among cases and 36.3 ng/mg (5%-95% range, 6.9-110.8 ng/mg) among controls. Women with lower ratios of 6-sulfatoxymelatonin to creatinine had increased risk of diabetes (multivariable odds ratio, 1.48 [95% CI, 1.11-1.98] per unit decrease in the estimated log ratio of 6-sulfatoxymelatonin to creatinine). Compared with women in the highest ratio category of 6-sulfatoxymelatonin to creatinine, those in the lowest category had a multivariable odds ratio of 2.17 (95% CI, 1.18-3.98) of developing type 2 diabetes. Women in the highest category of melatonin secretion had an estimated diabetes incidence rate of 4.27 cases/1000 person-years compared with 9.27 cases/1000 person-years in the lowest category.

CONCLUSIONS AND RELEVANCE:

Lower melatonin secretion was independently associated with a higher risk of developing type 2 diabetes. Further research is warranted to assess if melatonin secretion is a modifiable risk factor for diabetes within the general population.

• Authors: Ciaran J McMullan, Eva S Schernhammer, Eric B Rimm, Frank B Hu, John P Forman
• Journal: JAMA (JAMA) Vol. 309 Issue 13 Pg. 1388-96 (Apr 03 2013) ISSN: 1538-3598 [Electronic] United States
• PMID: 23549584 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• 6-sulfatoxymelatonin
• Creatinine
• Melatonin

Topics

• Aged
• Case-Control Studies
• Cohort Studies
• Creatinine (urine)
• Diabetes Mellitus, Type 2 (epidemiology)
• Female
• Humans
• Incidence
• Melatonin (analogs & derivatives, metabolism, urine)
• Middle Aged
• Regression Analysis
• Risk Factors
• United States (epidemiology)