Fatigued Patients with Chronic Liver Disease Have Subtle Aberrations of Sleep, Melatonin and Cortisol Circadian Rhythms

Autor:	Michele M. Tana, Ashura Buckley, Shanna Bernstein, Kong Y. Chen, Nevitt Morris, Rahiya Binte Rehman, Robert J. Brychta, Souvik Sarkar, Yaron Rotman, Xiongce Zhao, Hawwa Alao, Mary Walter, Jacob D. Hattenbach
Rok vydání:	2018
Předmět:	0301 basic medicine business.industry Public Health Environmental and Occupational Health Medicine (miscellaneous) Physiology medicine.disease Chronic liver disease Sleep in non-human animals Article Peripheral Melatonin 03 medical and health sciences Behavioral Neuroscience Liver disease 030104 developmental biology 0302 clinical medicine medicine 030211 gastroenterology & hepatology In patient Circadian rhythm business medicine.drug
Zdroj:	Fatigue : biomedicine, healthbehavior. 6(1)
ISSN:	2164-1846
Popis:	We sought to examine whether disturbances in central and peripheral circadian rhythms were related to the experience of fatigue in patients with chronic liver disease (CLD).Fatigued and non-fatigued patients with compensated CLD were enrolled in a prospective pilot study. Patients underwent a one week evaluation of free-living sleep and physical activity patterns, followed by a 24-hour admission, during which they underwent serial blood sampling, polysomnography, a 6-minute walk test and continuous core temperature measurements under standardized conditions. Blood samples were analyzed for liver tests, melatonin levels, lipids, and cortisol. Circadian rhythms were analyzed using single cosinor analyses.Six fatigued and six non-fatigued patients were studied; five participants had cirrhosis. Fatigue severity was positively associated higher peak melatonin levels (rho=0.59, p=0.04) and a delay in night-time melatonin peak and inversely associated with sleep efficiency (rho=-0.63, p=0.04). Polysomnography, 6-minute walk test, and core temperature measurements did not differ significantly between the fatigued and non-fatigued patients. Although liver enzymes, bilirubin and albumin demonstrated a circadian pattern, it was not associated with fatigue. Fatigued patients showed a blunted and delayed cortisol rhythm and fatigue was strongly correlated with cortisol amplitude (rho=-0.77, p=0.004) and phase (r=-0.66, p=0.02).Subtle aberrations in melatonin and adrenal circadian rhythms, as well as reduced sleep efficiency, likely contribute to fatigue in patients with CLD. These abnormalities may ultimately be a therapeutic target to improve quality of life for fatigued patients with CLD.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6f2428e03735d2b3b63afc29314bd054 https://pubmed.ncbi.nlm.nih.gov/30546968 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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