Reference intervals for 6-sulfatoxymelatonin in urine: A meta-analysis

Braam, Wiebe; Spruyt, Karen

doi:10.1016/j.smrv.2022.101614

Cited by 7 publications

(8 citation statements)

References 86 publications

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“…The Study Quality Assessment Tools of the National Institutes of Health (NIH) [ 24 ] applicable to several study designs were used for scoring study quality [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Literature Cases Summarized Based on Their Polysomnographic Findings in Rett Syndrome

Zhang

Spruyt

2022

IJERPH

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Rett syndrome (RTT) is a severe and rare neurodevelopmental disorder affecting mostly girls. In RTT, an impaired sleep pattern is a supportive criterion for the diagnosis, yet little is known regarding the sleep structure and sleep respiratory events. Aiming to delineate sleep by aggregating RTT case (series) data from published polysomnographic studies, seventy-four RTT cases were collected from eleven studies up until 6 February 2022 (PROSPERO: CRD 42020198099). We compared the polysomnographic data within RTT stratifications and to a typically developing population. MECP2 cases demonstrated shortened total sleep time (TST) with increased stage N3 and decreased REM sleep. In cases with CDKL5 mutations, TST was longer and they spent more time in stage N1 but less in stage N3 than those cases affected by MECP2 mutations and a typically developing population. Sleep-disordered breathing was confirmed by the abnormal apnea/hypopnea index of 11.92 ± 23.67/h TST in these aggregated cases. No association of sleep structure with chronological age was found. In RTT, the sleep macrostructure of MECP2 versus CDKL5 cases showed differences, particularly regarding sleep stage N3. A severe REM sleep propensity reduction was found. Aberrant sleep cycling, possibly characterized by a poor REM ‘on switch’ and preponderance in slow and high-voltage sleep, is proposed.

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“…The Study Quality Assessment Tools of the National Institutes of Health (NIH) [ 24 ] applicable to several study designs were used for scoring study quality [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Literature Cases Summarized Based on Their Polysomnographic Findings in Rett Syndrome

Zhang

Spruyt

2022

IJERPH

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“…This tool applies to several study designs. We followed the same approach as published ( 30 , 31 ). Study quality was regrouped on four domains: “study population, definition and selection,” “soundness of information,” “analysis, comparability, and outcomes,” and “interpretation and reporting,” and evaluated as poor, fair, and good.…”

Section: Methodsmentioning

confidence: 99%

A meta-review of standard polysomnography parameters in Rett Syndrome

Zhang

Spruyt²

2022

Front. Neurol.

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Rett Syndrome (RTT, OMIM 312750), a unique rare neurodevelopmental disorder, mostly affects females and causes severe multi-disabilities including poor sleep. This meta-analysis systematically reviewed the polysomnographic (PSG) data of individuals with RTT on both sleep macrostructure and sleep respiratory indexes and compared them to literature normative values. Studies were collected from PubMed, Web of Science, PsycINFO, Ebsco, Scopus, and Cochrane Library till 26 April 2022. Across 13 included studies, the 134 selected RTT cases were mostly females being MECP2 (n = 41) and CDKL5 (n = 4) positive. They were further stratified by gene, age, and clinical features. Findings of comparison with literature normative values suggested shorter total sleep time (TST) and sleep onset latency (SOL), twice as long wake after sleep onset (WASO) with lower sleep efficiency (SEI) in RTT, as well as increased non-rapid eye movement stage 3 (stage N3) and decreased rapid eye movement sleep. Based on limited data per stratifications, we found in RTT cases <5 years old lower stage N3, and in RTT cases >5 years old less WASO and more WASO in the epileptic strata. However, meta-results generated from studies designed with comparison groups only showed lower stage N1 in RTT than in healthy comparison, together with similar SEI and stage N3 to primary snoring subjects. For sleep respiratory indexes, severe disordered sleep breathing was confirmed across roughly all RTT strata. We are the first study to meta-analyze PSG data of subjects with RTT, illustrating shorter TST and aberrant sleep staging in RTT that may vary with age or the presence of epilepsy. Severe nocturnal hypoxemia with apneic events was also demonstrated. More studies are needed to explore and elucidate the pathophysiological mechanisms of these sleep findings in the future.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=198099, identifier: CRD 42020198099.

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“…The primary models included a single exposure variable (corona mass ejection energy, speed or mass) and covariates. Melatonin can be affected by sex, seasonal changes, medications (including β-blockers and non-steroidal anti-inflammatory drugs), sleep apnea, and comorbidities including diabetes [2,[13][14][15][16][17][18][19][20]. Therefore, model covariates included a priori were race (white vs. other), sex (male/female), age, body mass index (BMI), beta blocker use and non-steroidal anti-inflammatory medication use within 1 day of urine collection, diabetes, time of urine collection, history of sleep apnea, and season (winter, spring, summer, fall), and BMI.…”

Section: Discussionmentioning

confidence: 99%

“…Circulating melatonin has a short half-life (~ up to 45 min) and is rapidly metabolized in the liver with the major enzymatic metabolite of melatonin (aMT6s), which highly correlates with plasma melatonin levels [13,14]. Studies in animals have suggested a link between seasonal rhythmicity of aMT6s levels and ~ 11-year solar cycles [8].…”

Section: Introductionmentioning

confidence: 99%

“…Studies in animals have suggested a link between seasonal rhythmicity of aMT6s levels and ~ 11-year solar cycles [8]. Melatonin levels can also be affected by genetic factors, sex, pineal gland size, and modifiable factors such as seasonal changes, latitudinal locations, medications (e.g., β-blockers and non-steroidal anti-inflammatory drugs), sleep quality, depression, smoking status, and comorbidities including diabetes and cancer [2,[13][14][15][16][17][18][19][20]. Levels of melatonin vary throughout life, reaching highest levels in children younger than 4 years, and declining within age [2,19].…”

Section: Introductionmentioning

confidence: 99%

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Intense solar activity reduces urinary 6-sulfatoxymelatonin in patients with COPD

et al. 2023

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Background Little is known about the link between solar activity and variations in melatonin. In this study, we investigated if melatonin's major urinary metabolite, urinary 6-sulfatoxymelatonin (aMT6s), is lowest under periods of intense solar activity. Methods We investigated associations between high-energy solar particle events [Coronal Mass Ejection (CME) mass, speed and energy] on creatinine-adjusted aMT6s (aMT6sr) concentrations in 140 patients with chronic obstructive pulmonary disease (COPD) using up to four seasonal urine samples (n = 440). Mixed effect models with a random intercept for each subject were used to estimate associations, including effect modification attributable to diabetes, obesity, and reduced pulmonary function. Results Higher values of CME were associated with reduced aMT6sr concentrations, with stronger associations in patients with diabetes. An interquartile range (IQR) increase in natural log CMEspeed averaged through two days before urine collection was associated with a reduction of 9.3% aMT6sr (95%CI: − 17.1%, − 0.8%) in aMT6sr. There was a greater reduction in aMT6sr in patients with diabetes (− 24.5%; 95%CI: − 35.9%, − 11.6%). In patients without diabetes there was no meaningful association (− 2.2%; 95%CI: − 12%, 8.4%). There were similar associations with CMEenergy and CMEmass. There was no effect modification attributable to reduced pulmonary function or obesity. Conclusions This is the first study in patients with COPD to demonstrate strong detrimental impact of high-energy solar particle events on aMT6sr, with greater associations in patients with diabetes. Since melatonin is an anti-oxidant, it is possible that adverse effects of intense solar activity may be attributable to a reduction in circulating melatonin and that patients with both COPD and diabetes may be more susceptible.

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Reference intervals for 6-sulfatoxymelatonin in urine: A meta-analysis

Cited by 7 publications

References 86 publications

Literature Cases Summarized Based on Their Polysomnographic Findings in Rett Syndrome

Literature Cases Summarized Based on Their Polysomnographic Findings in Rett Syndrome

A meta-review of standard polysomnography parameters in Rett Syndrome

Intense solar activity reduces urinary 6-sulfatoxymelatonin in patients with COPD

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