Low melatonin secretion associated with increased type 2 diabetes risk

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1. Women with lower melatonin secretion had a significantly higher incidence of type 2 diabetes.

2. Women with a higher melatonin secretion had lower BMI, as well as decreased inflammatory markers and prevalence of hypertension.

Study Rundown: This case-control study demonstrates an interesting association between melatonin secretion and type 2 diabetes mellitus. In a sample of women from the Nurses’ Health Study cohort, lower melatonin secretion was associated with a significantly higher risk of developing type 2 diabetes. Inspired by the protective role melatonin appears to play in insulin sensitivity and diabetes disease progression in animal studies, the authors suggest that decreased melatonin secretion may herald metabolic disease. While this study was well-designed, it has a number of limitations which should be considered. It included only women, whose metabolic and hormonal responses may not be generalizable to men. Similarly, melatonin rodent studies often cannot be directly applicable to humans, as their sleep-wake behavior is reversed. We also cannot clarify a causal role as the biological mechanism behind the finding has not been elucidated. Further research should validate these findings and elucidate a better mechanistic understanding of the association.

Such research will be important, as melatonin is one of many in the symphony of hormones governing metabolism, and we may just be observing a bystander effect. Nevertheless, it is well-described that increasing endogenous melatonin levels via sleep hygiene or even exogenous supplementation can improve sleep, which would in turn support healthier protoplasm. In practice, this study indirectly reaffirms the importance of sleep quality in preventing metabolic disease.

Click to read the study in JAMA

In Depth [case-control study]: The study used a subgroup within the Nurses’ Health Study. Three hundred and seventy women who developed type 2 diabetes between 2000 and 2012 were age-matched to controls. All had their melatonin secretion estimated by morning urine 6-sulfatoxymelatonin levels (normalized to creatinine). The median ratio of 6-sulfatoxymelatonin to creatinine was significantly higher among controls (p < 0.001). Women with a higher ratio of 6-sulfatoxymelatonin also had lower BMI, inflammatory markers and prevalence of hypertension.

By Mike Hoaglin and Rif Rahman

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