MELATONIN AND THE METABOLIC SYNDROME

ELEONORA S. PAGANO; PABLO A. SCACCHI BERNASCONI; ROXANA REYNOSO; PABLO SCACCHI; DANIEL P. CARDINALI

New Developments in Melatonin Research

NOVA SCIENCE PUBLISHERS, INC

Lugar: NY; Año: 2013; p. 101 - 119

Circadian disruption and sleep deprivation in contemporary ?24/7 Society? lead to the predominance of pro-orexic and proinflammatory mechanisms that contribute to the high prevalence of obesity, diabetes and cardiovascular disease, all constituents of the metabolic syndrome (MS). Besides changes in life style, a successful therapy for MS requires a drug able to antagonize the trigger factors of MS and to correct the disturbed circadian rhythmicity observed in MS. This chapter deals with the analysis of the therapeutic validity of melatonin to fulfill that objective in MS. As an effective chronobiotic agent, melatonin can change the phase and the amplitude of the sleep/wake rhythm. In addition, it has cytoprotective and immunomodulatory properties that can be useful to prevent a number of MS sequelae including obesity, diabetes and cardiovascular disease. Melatonin prevents hyperadiposity in animal models of obesity and there is preliminary information that in low doses (2-5 mg/day) melatonin may curtail MS in humans. More recently, attention has been focused on the development of potent melatonin analogs with prolonged effects (ramelteon, agomelatine, tasimelteon). In clinical trials these analogs were employed in doses considerably higher than those usually employed for melatonin to treat insomnia and other sleep disorders, and as antidepressants. Clinical trials employing melatonin doses in the range of 50-100 mg/day are needed to assess its therapeutic value in MS.