Supamas Sirisreetreerux1, Tharikarn Sujirakul2, Hataikarn Nimitphong1, Sittichai Pinyopodjanard1, Sunee Saetung1, La-Or Chailurkit1, Naricha Chirakalwasan3,4, Ben S Gerber5, Sirimon Reutrakul6,7. 1. Division of Endocrinology and Metabolism, Mahidol University, Bangkok, Thailand. 2. Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 3. Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. 4. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 5. Division of Academic Internal Medicine and Geriatrics, University of Illinois at Chicago, Chicago, IL, USA. 6. Division of Endocrinology and Metabolism, Mahidol University, Bangkok, Thailand. sreutrak@uic.edu. 7. Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, 835 S. Wolcott Street, suite 625E, Chicago, IL, 60612, USA. sreutrak@uic.edu.
Abstract
PURPOSE: Recent evidence suggests that diabetic retinopathy (DR) is associated with abnormal melatonin regulation, possibly related to dysfunction of the melanopsin-expressing intrinsically photosensitive retinal ganglion cells. This study explored melatonin regulation in type 2 diabetes (T2D) patients with DR and its relation to sleep and circadian functioning. METHODS: Thirty-five participants (10 non-diabetic controls, 10 T2D without DR, and 15 T2D with DR) were recruited. Overnight urine 6-sulfatoxymelatonin (aMT6s) and objective sleep and wrist activity (7-day actigraphy) were obtained. RESULTS: After adjusting for covariates, having T2D with DR was significantly associated with lower urinary aMT6s (β = - 1.369, p = 0.004) compared with controls, while having T2D without DR was not (p = 0.418). T2D patients with DR reported poorer sleep quality (p = 0.014) and had greater variability of sleep duration (p = 0.017) than others, while no differences were found in sleep duration, efficiency, and rest-activity rhythm. After adjusting for covariates, lower nocturnal aMT6s was significantly associated with greater sleep variability. CONCLUSION: T2D patients with DR exhibited low overnight production of aMT6s which likely contributed to sleep irregularities possibly due to weak circadian signaling. Whether or not melatonin supplementation could improve health in T2D patients with DR remains to be explored.
PURPOSE: Recent evidence suggests that diabetic retinopathy (DR) is associated with abnormal melatonin regulation, possibly related to dysfunction of the melanopsin-expressing intrinsically photosensitive retinal ganglion cells. This study explored melatonin regulation in type 2 diabetes (T2D) patients with DR and its relation to sleep and circadian functioning. METHODS: Thirty-five participants (10 non-diabetic controls, 10 T2D without DR, and 15 T2D with DR) were recruited. Overnight urine 6-sulfatoxymelatonin (aMT6s) and objective sleep and wrist activity (7-day actigraphy) were obtained. RESULTS: After adjusting for covariates, having T2D with DR was significantly associated with lower urinary aMT6s (β = - 1.369, p = 0.004) compared with controls, while having T2D without DR was not (p = 0.418). T2D patients with DR reported poorer sleep quality (p = 0.014) and had greater variability of sleep duration (p = 0.017) than others, while no differences were found in sleep duration, efficiency, and rest-activity rhythm. After adjusting for covariates, lower nocturnal aMT6s was significantly associated with greater sleep variability. CONCLUSION: T2D patients with DR exhibited low overnight production of aMT6s which likely contributed to sleep irregularities possibly due to weak circadian signaling. Whether or not melatonin supplementation could improve health in T2D patients with DR remains to be explored.
Authors: M D Davis; M R Fisher; R E Gangnon; F Barton; L M Aiello; E Y Chew; F L Ferris; G L Knatterud Journal: Invest Ophthalmol Vis Sci Date: 1998-02 Impact factor: 4.799
Authors: Shakoor Ba-Ali; Adam Elias Brøndsted; Henrik Ullits Andersen; Birgit Sander; Poul Jørgen Jennum; Henrik Lund-Andersen Journal: Sleep Med Date: 2018-10-31 Impact factor: 3.492
Authors: Jason C Park; Yi-Fan Chen; Norman P Blair; Felix Y Chau; Jennifer I Lim; Yannek I Leiderman; Mahnaz Shahidi; J Jason McAnany Journal: Sci Rep Date: 2017-03-23 Impact factor: 4.379
Authors: Sirimon Reutrakul; Stephanie J Crowley; Jason C Park; Felix Y Chau; Medha Priyadarshini; Erin C Hanlon; Kirstie K Danielson; Ben S Gerber; Tracy Baynard; Jade J Yeh; J Jason McAnany Journal: Sci Rep Date: 2020-01-31 Impact factor: 4.379