The Fluctuations of Melatonin and Copeptin Levels in Blood Serum During Surgical Stress Regarding the Pediatric Population

Abstract

Introduction: Copeptin is known to be associated with heart damage, while melatonin is a regulatory hormone associated with circadian rhythm and represents the levels of inflammation in the body. Methods and patients: The aim of the study was to measure in different surgeries the levels of copeptin and melatonin at different times before and after surgery in 56 patients aged from 5 days to 13.6 years. We measured copeptin in 50-microL serum and plasma samples from patients before surgery, immediately after surgery, and 24 hours after surgery. The measured levels are aligned with the published GC / MS data and the sensitivity of the analysis is such that serum and plasma levels can only be measured by rapid extraction. The measurement was made before surgery, immediately after surgery and 24 hours after surgery. Results: The multifactorial statistical analysis revealed a statistically significant difference between the 24-hour postoperative copeptin values in group 1 (mild-moderate gravity surgery) and group 2 (severe surgery) of the severity of the surgery. Post-hoc tests with Tukey correction for age groups in multiple comparisons of multifactorial analysis revealed a statistically significant difference (p <0.05) between 24-hour postoperative melatonin values in age group 3 (3-6 years) and 5 (6-12 years old). The age group 3 showed significantly (p <0.05) lower 24 hours postoperative melatonin values compared to the age group 5 (6-12 years). Again, these 3-6 year olds were more likely to have inflammation due to the severity of the surgery and the presence of inflammation after the surgery. Discussion: In summary, copeptin is a reliable biomarker for assessing a patient's health both preoperatively and postoperatively. Copeptin and melatonin are two independent agents and are not related to each other, and more studies will be needed with more patients of the same age and with the same underlying disease to assess their diagnostic value. Finally, melatonin could be considered an indicator of inflammation on its own and based on pre- and post-surgery values to assess a patient's health status and take appropriate actions.

Melatonin in Newborn Infants Undergoing Surgery: A Pilot Study on Its Effects on Postoperative Oxidative Stress

“…Alterations in plasma levels of melatonin, due to surgical stress, have been also demonstrated in the pediatric population [ 22 ] with a reduction in melatonin values in the postoperative time, at 24 h, that was significantly higher in patients aged between 3 and 6 years of age compared with patients at 6–12 year of age. The difference between neonatal and pediatric patients may be due to the irregular secretion of melatonin in the first years of life.…”

“…A multifactorial analysis in the paper by Dragoumi et al revealed a statistically significant difference between 24 h postoperative melatonin values in age groups three (3–6 years) and five (6–12 years old). Age group three (3–6 years) showed significantly lower postoperative melatonin values compared with age group five (6–12 years) [ 22 ].…”