The University of Southampton
University of Southampton Institutional Repository

Impaired nocturnal melatonin in acute phase of ischaemic stroke: cross-sectional matched case-control analysis

Atanassova, Penka A., Terzieva, Dora D. and Dimitrov, Borislav D. (2009) Impaired nocturnal melatonin in acute phase of ischaemic stroke: cross-sectional matched case-control analysis Journal of Neuroendocrinology, 21, (7), pp. 657-663. (doi:10.1111/j.1365-2826.2009.01881.x).

Record type: Article

Abstract

Quantitative data on melatonin in stroke patients are scarce. A gender- and age-matched cross-sectional case–control study in 33 patients with ischaemic stroke was performed and associations between nocturnal melatonin and other factors (e.g. cortisol) were evaluated. Clinical and laboratory (e.g. melatonin and cortisol) measurements (03.00 h and 08.00 h) with statistical techniques [e.g. multifactorial regressions, receiver operating characteristic (ROC) curve and curvilinear estimations] were used. We identified mean value and 95% confidence interval (CI) (69.70 pg/ml; 95% CI = 53.86–85.54) for control levels of nocturnal melatonin in healthy subjects. The patients with stroke had lower melatonin (48.1 ± 35.9 pg/ml) and higher cortisol (297.3 ± 157.8 nmol/l) at 03.00 h (P < 0.05) but not at 08.00 h (P > 0.05). Stroke was the strongest factor of disturbed nocturnal cortisol (P < 0.001), whereas decreased melatonin depended on stroke (P = 0.010) and gender (P = 0.018). At the same time, vice versa, only nocturnal measures were associated with an increased probability of the presence of stroke (accuracy > 75%, Pmodel < 0.001). Thus, a hypothesis that a decrease of melatonin with 1.0 pg/ml might be associated with > 2% increase in the probability of the presence of stroke [adjusted odds ratio (OR) = 1.020; 95% CI = 1.002–1.037] was also suggested. The ROC curve (0.67, P = 0.0119) and optimisation techniques indicated that a novel best cut-off < 51.5 pg/ml for decreased nocturnal melatonin in the view of the presence of stroke (OR = 3.12, P = 0.0463) might exist. The classification performance of such a cut-off might be confirmed by existing nocturnal melatonin and cortisol differences between the sub-groups; potential differences in diurnal melatonin were also suggested. In conclusion, a novel melatonin cut-off of 51.5 pg/ml may be associated with the presence of ischaemic stroke. As a single marker (84% sensitivity, 74% specificity), it is hypothesised that modelling performance was independent of age, gender and cortisol. These new results, including the suggested hypothesis, might be further tested in follow-up (cohort), longitudinal studies and be applied to explore melatonin disturbances as targets in high-risk pre-stroke and post-stroke patients

Full text not available from this repository.

More information

e-pub ahead of print date: 29 April 2009
Published date: July 2009
Keywords: melatonin, cortisol, modelling, acute ischaemic stroke, bulgaria
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 337414
URI: http://eprints.soton.ac.uk/id/eprint/337414
ISSN: 0953-8194
PURE UUID: af827b4f-4106-4831-885a-3461063a85c4

Catalogue record

Date deposited: 25 Apr 2012 13:45
Last modified: 18 Jul 2017 06:03

Export record

Altmetrics

Contributors

Author: Penka A. Atanassova
Author: Dora D. Terzieva
Author: Borislav D. Dimitrov

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×