Total 24-Hour Melatonin Secretion in Adolescent Idiopathic Scoliosis

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Abstract
STUDY DESIGN: A case-control study of 24-hour urinary melatonin production in patients with adolescent idiopathic scoliosis. OBJECTIVES: To address the controversy over the role of melatonin deficiency in adolescent idiopathic scoliosis by measuring total melatonin production over a 24-hour period. SUMMARY OF BACKGROUND DATA: An association between melatonin deficiency and experimental scoliosis has been suggested in several animal species. Recent work has failed to show a deficiency in humans with scoliosis. However, this conclusion was based on single urinary estimations. In this study the period assayed was standardized to 24-hours for all patients to include the full diurnal cycle of melatonin excretion. METHODS: Consecutive patients at an outpatient clinic for adolescent idiopathic scoliosis were recruited as subjects for this study, and patients from a fracture clinic who were of similar age and gender were recruited as controls at their final follow-up examination after the healing of their fracture. Patients and control individuals collected urine over a 24-hour period that was divided into consecutive day and night collections of 12 hours each. Total urinary excretion of 6-sulphatoxy melatonin was determined by radioimmunoassay for each 12-hour period in patients and control individuals. RESULTS: No significant difference in diurnal, nocturnal, or total urine 6-sulphatoxy melatonin excretion was found between adolescent patients with idiopathic scoliosis and controls of similar age and gender. There was also no difference between the two groups when 6-sulphatoxy melatonin excretion was corrected for body weight, body surface area, and body mass index. Nor was there a significant difference between 6-sulphatoxy melatonin excretion of patients with scoliosis whose curves failed to progress over the course of a year and the excretion of those who underwent surgery. CONCLUSIONS: In adolescent idiopathic scoliosis, neither the presentation with a stable spinal deformity, nor presentation with a severe deformity requiring surgery is associated with melatonin deficiency

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