Abstract：
BACKGROUND: Circadian dysregulation has long been thought to be a key component in the pathophysiology of bipolar disorder (BD). However, it remains unclear whether this dysregulation constitutes a risk factor, manifestation, or consequence of BD. This study aimed to compare dim light melatonin secretion patterns between unaffected offspring of parents with BD (OBD) and offspring of control parents (OCP).
METHODS: This case-control study included unaffected OBD (mean age 14.0 years; male 50.0 %) and age- and sex-matched OCP (mean age 13.0 years; male: 43.5 %). Seventeen saliva samples were collected in dim light conditions. Dim light melatonin onset (DLMO), phase angles, and area under the curve (AUC) were calculated.
RESULTS: 185 saliva samples from 12 OBD (n = 12) and 741 from OCP (n = 46) were collected. Unaffected OBD had a significant lower nocturnal melatonin level (14.8 ± 4.6 vs. 20.3 ± 11.7 pg/mL) and a smaller melatonin AUC within two hours after DLMO (35.5 ± 11.3 vs. 44.6 ± 18.1 pg/mL) but a significant larger phase angle between DLMO and sleep onset (2.2 ± 1.0 vs. 1.4 ± 1.2 h) than OCP. There was no significant between-group difference in DLMO. The graphic illustrations showed a considerably flattened melatonin secretion in unaffected OBD.
CONCLUSIONS: The main limitations include lack of 24-h dim melatonin secretion measurement, large age range of participants, and small sample size.
CONCLUSIONS: These findings suggest that unaffected OBD already presented with circadian rhythm dysregulations. Future investigations are needed to clarify the role of abnormal melatonin secretion in the onset of BD.
METHODS: This case-control study included unaffected OBD (mean age 14.0 years; male 50.0 %) and age- and sex-matched OCP (mean age 13.0 years; male: 43.5 %). Seventeen saliva samples were collected in dim light conditions. Dim light melatonin onset (DLMO), phase angles, and area under the curve (AUC) were calculated.
RESULTS: 185 saliva samples from 12 OBD (n = 12) and 741 from OCP (n = 46) were collected. Unaffected OBD had a significant lower nocturnal melatonin level (14.8 ± 4.6 vs. 20.3 ± 11.7 pg/mL) and a smaller melatonin AUC within two hours after DLMO (35.5 ± 11.3 vs. 44.6 ± 18.1 pg/mL) but a significant larger phase angle between DLMO and sleep onset (2.2 ± 1.0 vs. 1.4 ± 1.2 h) than OCP. There was no significant between-group difference in DLMO. The graphic illustrations showed a considerably flattened melatonin secretion in unaffected OBD.
CONCLUSIONS: The main limitations include lack of 24-h dim melatonin secretion measurement, large age range of participants, and small sample size.
CONCLUSIONS: These findings suggest that unaffected OBD already presented with circadian rhythm dysregulations. Future investigations are needed to clarify the role of abnormal melatonin secretion in the onset of BD.
摘要：
背景：昼夜节律失调一直被认为是双相情感障碍（BD）病理生理学的关键组成部分。然而,目前尚不清楚这种失调是否构成风险因素，表现，或BD的后果。这项研究旨在比较BD父母（OBD）未受影响的后代和对照父母（OCP）后代之间的弱光褪黑激素分泌模式。
方法：本病例对照研究包括未受影响的OBD（平均年龄14.0岁；男性50.0%）和年龄和性别匹配的OCP（平均年龄13.0岁；男性：43.5%）。在暗光条件下收集十七个唾液样品。弱光褪黑激素（DLMO），相位角,计算曲线下面积(AUC)。
结果：收集了来自12个OBD（n=12）的185个唾液样品和来自OCP（n=46）的741个唾液样品。未受影响的OBD夜间褪黑激素水平显着降低（14.8±4.6vs.20.3±11.7pg/mL）和DLMO后两小时内较小的褪黑激素AUC（35.5±11.3vs.44.6±18.1pg/mL），但DLMO和睡眠开始之间的相位角明显更大（2.2±1.0vs.1.4±1.2h)比OCP高。DLMO组间差异无统计学意义。图形说明显示未受影响的OBD中褪黑激素分泌相当平坦。
结论：主要限制包括缺乏24小时昏暗的褪黑激素分泌测量，参与者的年龄范围很大，样本量小。
结论：这些研究结果表明未受影响的OBD已经出现昼夜节律失调。需要进一步的研究来阐明褪黑激素分泌异常在BD发作中的作用。
方法：本病例对照研究包括未受影响的OBD（平均年龄14.0岁；男性50.0%）和年龄和性别匹配的OCP（平均年龄13.0岁；男性：43.5%）。在暗光条件下收集十七个唾液样品。弱光褪黑激素（DLMO），相位角,计算曲线下面积(AUC)。
结果：收集了来自12个OBD（n=12）的185个唾液样品和来自OCP（n=46）的741个唾液样品。未受影响的OBD夜间褪黑激素水平显着降低（14.8±4.6vs.20.3±11.7pg/mL）和DLMO后两小时内较小的褪黑激素AUC（35.5±11.3vs.44.6±18.1pg/mL），但DLMO和睡眠开始之间的相位角明显更大（2.2±1.0vs.1.4±1.2h)比OCP高。DLMO组间差异无统计学意义。图形说明显示未受影响的OBD中褪黑激素分泌相当平坦。
结论：主要限制包括缺乏24小时昏暗的褪黑激素分泌测量，参与者的年龄范围很大，样本量小。
结论：这些研究结果表明未受影响的OBD已经出现昼夜节律失调。需要进一步的研究来阐明褪黑激素分泌异常在BD发作中的作用。
