Lower Melatonin Indicates Poor Short-term Prognosis in Patients with Acute Ischemic Stroke

Abstract

Aims: We evaluated endogenous melatonin levels in the acute phase of cerebral infarction and explored the impact of possible changes in melatonin levels on the prognosis of patients. Methods: This study recruited acute ischemic stroke (AIS) patients from the Department of the Second Affiliated Hospital of Soochow University between December 2019 and June 2021, along with healthy control subjects. Salivary melatonin samples were collected from each participant between 7 pm and 10 pm, and fasting plasma was collected the following morning to measure the levels of inflammatory markers. The prognosis was assessed through follow-up three months after discharge. The relationship between melatonin levels and plasma inflammatory markers was assessed, followed by an analysis of the effect of melatonin levels on patient prognosis. Results: The study enrolled a total of 160 participants, including 120 AIS patients aged 50 years or older (61.7% male) and 40 age-matched controls (55.0% male). The AIS group exhibited lower salivary melatonin levels at 19 (P = 0.002), 20 (P < 0.001), 21 (P < 0.001), and 22 (P < 0.001) o’clock, and the average melatonin level was also lower (P < 0.001). Logistic regression analysis models indicated an association between low melatonin levels and poor prognosis. Salivary melatonin levels demonstrated good predictive ability for the prognosis of AIS patients. method: This study selected acute ischemic stroke (AIS) patients from the Department of the Second Affiliated Hospital of Soochow University from December 2019 to June 2021. Healthy control subjects were recruited at the same time. Salivary melatonin samples were collected for each person from 7 pm to 10 pm, and fasting plasma was collected the next morning to measure inflammatory marker levels. Follow-up was performed after 3 months post discharge for prognosis. We assessed the relationship between melatonin levels and plasma inflammatory markers levels, and subsequently analyzed the effect of melatonin levels on patient prognosis. Conclusion: Melatonin levels were lower in AIS patients compared to controls. In addition, lower melatonin levels were associated with a poorer prognosis among AIS patients. result: A total of 160 participants were enrolled in this study, including 120 AIS patients aged ≥ 50 years (61.7% male) and 40 age-matched controls (55.0% male). The AIS group showed lower salivary melatonin levels at 19 (P = 0.002), 20 (P < 0.001), 21 (P < 0.001), and 22 (P < 0.001) o’clock, and the average melatonin level was also lower (P < 0.001). The logistic regression analysis models suggested that low melatonin levels were associated with poor prognosis. Salivary melatonin levels had a good predictive ability for the prognosis of AIS patients.