Urinary Melatonin Levels Sleep Disruption and Risk of Prostate Cancer in Elderly Men

摘要

Melatonin has anticarcinogenic properties in experimental models. We undertook a case–cohort study of 928 Icelandic men without prostate cancer (PCa) nested within the Age, Gene/Environment Susceptibility (AGES)-Reykjavik cohort to investigate the prospective association between first morning-void urinary 6-sulfatoxymelatonin (6-STM) levels and the subsequent risk for PCa, under the hypothesis that men with lower 6-STM levels have an increased risk for advanced PCa. We used weighted Cox proportional hazards models to assess the association between first morning-void 6-STM level and PCa risk, adjusting for potential confounders. A total of 111 men were diagnosed with incident PCa, including 24 with advanced disease. Men who reported sleep problems at baseline had lower morning 6-STM levels compared with those who reported no sleep problems. Men with morning 6-STM levels below the median had a fourfold statistically significant increased risk for advanced disease compared with men with levels above the median (hazard ratio: 4.04; 95% confidence interval, 1.26–12.98). These results require replication in larger prospective studies with longer follow-up.