Multipl sklerozlu hastalarda kan diurnal melatonin seviyesi ile görsel uyarılmış potansiyel latans değişiklikleri ve kan lipid profili ilişkisi

Amaç: Bilateral görsel uyarılmış potansiyel (GUP) P100 latansları uzun ve bilateral GUP P100 latansları normal olan multipl sklerozlu (MS) hastalarda serum melatonin diurnal seyrinin farklı olup olmadığını, serum melatonin ve serum lipid seviyeleri arasında ilişki bulunup bulunmadığını araştırmak. Yöntem: Bu çalışmaya akut MS atağı nedeniyle nöroloji servisine yatırılan 25 hasta (16 kadın, 9 erkek) alındı. Steroid tedavisi verilmeden önce 03.30 ve 10.00’da melatonin seviyelerine bakmak amacıyla hastalardan kan alındı. Serum melatonin seviyesine, lipid profili ve GUP P100 latanslarına bakıldı. Bulgular: GUP P100 latansları 110 milisaniyenin altında olan 8 hasta ile GUP latansları 110 ve 120 milisaniyenin üzerinde olan sırasıyla 17 ve 11 hasta arasında gece-gündüz serum melatonin ortalamaları ve gece-gündüz melatonin seviyeleri arasındaki düşme (baskılanma) oranları açısından anlamlı fark görülmedi. Kan lipid profili ile melatonin seviyeleri arasında anlamlı korelasyon bulunmadı. Sonuç: Gece-gündüz melatonin baskılanma oranları GUP P100 latansı yüksek olanlarda normale göre biraz düşük olsa da, fark anlamlı değildi. Bunda örnek sayısının az olmasının rolü olabilir. Bazı yayınların aksine kan lipid seviyeleri ile melatonin seviyeleri arasında ilişki bulunmadı.

Correlation with blood diurnal melatonin level to visual evoked potential latency changes and blood lipid profile in patients with multiple sclerosis

Objective: To investigate whether there was a difference between the patients with Multiple sclerosis (MS) with prolonged visual evoked potential (VEP) P100 latency and the patients with MS with normal VEP P100 latency. Methods: Twenty-five MS patients (16 female, 9 male) admitted to the clinic, because of the acute attack were included in the study. The blood was collected from the patients at 03.30 am and 10.00 am for determining melatonin level. Serum melatonin level, lipid profile and VEP P100 latency were determined. Results: There was no difference in both nocturnal and morning melatonin level and inhibition rate in melatonin level between the 8 patients in whom VEP P 100 latency was lower than 110 ms and 17 and 11 patients in whom VEP P100 latency was higher than 110 and 120 ms, respectively. Also there was no correlation between blood lipid profile and melatonin level. Conclusion: In MS patients in whom VEP P100 latency was higher, nocturnal-morning melatonin inhibition rate was somewhat lower than those in MS patients in whom VEP P100 latency was normal. The low amount of patients may be a reason for this situation. There was no correlation between blood lipid profile and melatonin level on the contrary to the literature.

Kaynakça

1. Sandyk R, Awerbuch GI. Nocturnal melatonin secretion in suicidal patients with multiple sclerosis. Int J Neurosci 1993; 71:173-82.

2. Miller JR. Multiple Sclerosis. In: Rowland LP, ed. Merritt’s Neurology. 10th ed. Philadelphia: Williams- Wilkins: 2000: 773-88.

3. Emerson PG, Pedley TA. Electroencephalography and Evoked Potentials. In: Bradley WG, Daroff RB, Fenichel GM, eds. Neurological Investigations and Related Clinical Neurosciences. 3rd ed. Philadelphia: Butterworth-Heinemann: 2000:486-88

4. İdiman F. Multipl sklerozda uyarılmış potansiyeller. Türkiye Klinikleri Nöroloji Dergisi 2004; 3:197-202.

5. Chokroverty S. Sleep disorders. In: Bradley WG, Daroff RB, Fenichel GM, eds. Neurological Diseases. 3rd ed. Butterworth-Heinemann 2000:1784-85.

6. Sandyk R, Awerbuch GI. Nocturnal melatonin secretion in multiple sclerosis patients with affective disorders. Int J Neurosci 1993;68:227-40.

7. Cam A, Erdoğan MF. Melatonin. Ankara Üniversitesi Tıp Fakültesi Mecm 2003;56:103-12.

8. Yazıcı C, Köse K. Melatonin: Karanlığın antioksidan gücü. E.Ü.Sağlık Bilimleri Derg 2004;13: 56-65.

9. Iguchi H, Kato K, Ibayashi H. Age dependent reduction in serum melatonin rhythm and its neurobiological consequences. Acta Neurobiol Exp 1994;54:31-39.

10. Arendt J. Melatonin. Clin Endocrinol 1988;29:205-29.

11. Pita ML, Hoyos M, Martin-Lacave I, Osuna C, Fernandez-Santos JM, Guerrero JM. Long-term melatonin administration increases polyunsaturated fatty acid percentage in plasma lipids of hypercholesterolemic rats. J Pineal Res 2002;32:179-86.

12. Tailleux A, Torpier G, Bonnefont-Rousselot D, Lestavel S, Lemdani M, Caudeville B, et al. Daily melatonin supplementation in mice increases atherosclerosis in proximal aorta. Biochem Biophys Res Common 2002;293:1114-23.

13. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis. Annals Neurol 2001; 50:121-7.

14. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurol 1983;33:1444-52.

15. Weaver DR, Stehle JH, Stopa EG, Reppert SM. Melatonin receptors in human hypothalamus and pituitary: Implications for circadian and reproductive responses to melatonin. J Clin Endocrinol Metab 1993;76:295-300.

16. Palaoğlu ÖS, Beşkonaklı E. Pineal bez ve yaşlanma. Turkish J Geriatrics 1998;1: 13-8.

17. Lockley SW, Skene DJ, Arendt J, Tabandeh H, Bird AC, Defrance R. Relationship between melatonin rhythms and visual loss in the blind. J Clin Endocrinol Metab 1997;82:3763-70.

18. Sandyk R, Awerbuch GI. The relationship between melatonin secretion and serum cholesterol in patients with multiple sclerosis. Int J Neurosci 1994;76:81-6.

19. Comoglu S, Yardımcı S, Okcu Z. Body fat distribution and plasma lipid profiles of patients with multiple sclerosis. Turk J Med Sci 2004 1:34;43-8.

Kaynak Göster