Melatonin: Manager of psychosomatic and metabolic disorders in polymorbid cardiovascular pathology

Alexander S Partsernyak; Victoria O Polyakova; Artem G Trufanov; Dmitriy S Medvedev; Dina V Trotsyuk; Kirill Markin; Evgeniy S Kurasov; Evgeniya V Kuznetsova; Alexander S Krasichkov

doi:10.3389/fnins.2022.989497

Melatonin: Manager of psychosomatic and metabolic disorders in polymorbid cardiovascular pathology

Front Neurosci. 2022 Sep 28:16:989497. doi: 10.3389/fnins.2022.989497. eCollection 2022.

Authors

Alexander S Partsernyak¹, Victoria O Polyakova², Artem G Trufanov^{3

4}, Dmitriy S Medvedev⁵, Dina V Trotsyuk⁶, Kirill Markin⁷, Evgeniy S Kurasov⁷, Evgeniya V Kuznetsova⁸, Alexander S Krasichkov⁹

Affiliations

¹ Department of Military Field Therapy, Kirov Military Medical Academy, Saint Petersburg, Russia.
² Center for Molecular Biomedicine, St. Petersburg Research Institute of Phthisiopulmonology, Saint Petersburg, Russia.
³ Department of Neurology, Kirov Military Medical Academy, Saint Petersburg, Russia.
⁴ Department of Software Engineering and Computer Applications, Saint Petersburg Electrotechnical University "LETI", Saint Petersburg, Russia.
⁵ Department of Physiological Assessment and Medical Correction, Research Institute of Hygiene, Occupational Pathology and Human Ecology of the Federal Medical Biological Agency of Russia, Kuzmolovsky, Russia.
⁶ Department of Internal Diseases, Private Educational Institution of Higher Education "St. Petersburg Medical and Social Institute", Saint Petersburg, Russia.
⁷ Department of Psychiatry, Kirov Military Medical Academy, Saint Petersburg, Russia.
⁸ Department of Medical Supply, Kirov Military Medical Academy, Saint Petersburg, Russia.
⁹ Department of Radio Engineering Systems, Saint Petersburg Electrotechnical University "LETI", Saint Petersburg, Russia.

Abstract

Objectives: To investigate the relationship between changes in circadian patterns of melatonin and clinical manifestations of polymorbid cardiovascular pathology (PCVP) in young men and to analyze the effectiveness of their complex treatment.

Materials and methods: We made the immunohistochemical (IHC) analysis of epiphysis tissues from autopsies of 25 men aged 32-44 with PCVP and metabolic syndrome (MS) who had died as a result of ischemic cardiomyopathy (IC) and 25 persons after the car accident as a control group. Then, 93 young men aged 35-44 with PCVP, metabolic syndrome, and depressive spectrum disorders (DSD) were divided into three groups: (1) standard therapy; (2) standard therapy and psychotherapy sessions; (3) standard therapy in combination with psychotherapeutic and psychophysiological visual and auditory correction sessions. The control group included 24 conditionally healthy male volunteers. Before and after the treatment, we studied the anthropometric status, lipid and carbohydrate metabolism indicators, the level of urinary 6-hydroxymelatonin sulfate, the degree of nocturnal decrease in blood pressure (BP), and the relationship of these indicators with circadian variations of melatonin excretion.

Results: Young polymorbid patients who died from IC have a lower expression of melatonin type 1 and 2 receptors. All patients with PCVP showed a decrease in the nocturnal melatonin excretion fraction and a correlation with higher severity of depressive (r = -0.72) and anxiety (r = -0.66) symptoms. Reduced values of the 6-hydroxymelatonin sulfate (6-SM) in the 1st (r = 0.45), 2nd (r = 0.39), and 3rd (r = 0.51) groups before treatment was associated with periods of increased BP. The achievement of melatonin excretion reference values and normalization of biochemical parameters of carbohydrate and lipid metabolism, daily BP profile, and psychophysiological state were noted in all three patients' groups, with a more pronounced effect in group 3.

Conclusion: Low nocturnal melatonin excretion levels are associated with greater severity of clinical symptoms and a higher risk of death in patients with PCVP. Therefore, comprehensive therapy may be more effective for correcting this disease.

Keywords: anxiety and depressive disorders; cardiovascular pathology; circadian rhythms; glucose; melatonin; metabolic syndrome; polymorbidity; young men.