Higher levels of melatonin in early stages of adolescent idiopathic scoliosis: toward a new scenario.
BACKGROUND
The melatonin deficiency hypothesis as a central mechanism in the pathogenesis of adolescent idiopathic scoliosis (AIS) is certainly intriguing. However, the actual role of melatonin remains unclear. The aim of this study was to assess the potential clinical value of melatonin serum level in the pathogenesis and the prognosis of AIS progression in patients who were treated nonoperatively.


METHODS
Two groups of patients were enrolled. The study group consisted of patients with AIS aged below 14 years who were treated conservatively. In the second group, that is, the control group, age-matched, weight-matched, and height-matched healthy individuals were enrolled. Blood samples were collected from all patients on visit 1 and the serum levels of melatonin were evaluated with the enzyme-linked immunosorbent assay (ELISA) method. The blood sampling procedure was repeated exactly 1 year later (visit 2).


RESULTS
Forty-two patients formed the study group (with AIS) and 29 served as the control group. The mean serum value of melatonin on visit 1 was 19.32 pg/mL for the AIS group and 12.23 pg/mL for the control group. This difference was statistically significant (P = 0.014). One year later, 34 patients from the AIS group and 23 from the control group were reevaluated and the mean serum levels of melatonin were 52.43 and 68.44 pg/mL, respectively. No statistically significant difference was found between the 2 groups (P = 0.235). Statistical analysis of the serum melatonin levels of patients with progressing AIS (>5 degrees of the Cobb angle in 1 y) when compared with patients with stable AIS (P = 0.387) or the control group (P = 0.727) failed to show that the deficiency of melatonin may be associated with the progression of AIS.


CONCLUSIONS
Higher melatonin levels were observed in conservatively treated patients with AIS, whereas melatonin deficiency was not associated with AIS progression in this study.


METHODS
Level III-case-control study.
*3rd Orthopaedic Department †2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki-Medical School, Papageorgiou General Hospital, Thessaloniki, Greece.
Theodoros T
TT
Goultidis
Kyriakos A
KA
Papavasiliou
Anastasios S
AS
Petropoulos
Antonios
A
Philippopoulos
George A
GA
Kapetanos
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000097:blood* / Q000172:deficiency*; D011446:Prospective Studies; D012600:Scoliosis / Q000097:blood* / Q000209:etiology; D012720:Severity of Illness Index
D015415:Biomarkers; D008550:Melatonin