The value of melatonin supplementation in postmenopausal women with Helicobacter pylori-associated dyspepsia

Cezary Chojnacki, Marta Mędrek-Socha, Paulina Konrad, Jan Chojnacki, Aleksandra Błońska, Cezary Chojnacki, Marta Mędrek-Socha, Paulina Konrad, Jan Chojnacki, Aleksandra Błońska

Abstract

Background: Dyspeptic syndrome is particularly common in postmenopausal women in the form of epigastric pain. The aim of the study was to assess the role of melatonin in chronic dyspepsia in this group of women, and examine the role of Helicobacter infection.

Methods: The study comprised 152 subjects including 30 healthy women (Group I), 60 women with asymptomatic H.pylori infection (Group II), and 64 women with H. pylori infection with chronic dyspepsia (Group III). Endoscopic examination was performed, as well as histological assessment of gastric end duodenal mucosa, urease breath test (UBT-13C), and immunoenzymatic assessment of serum 17-β-estradiol, follicle stimulating hormone and melatonin, and urinary 6-sulfatoxymelatonin. In Group III, 14-day antibacterial treatment was introduced with pantoprazole, amoxicillin and levofloxacin followed a six-month treatment with placebo in 32 women (Group IIIa), and melatonin 1 mg/morning and 3 mg/at bedtime in the other 32 women (Group IIIb).

Results: No significant differences were found between serum level of female hormone. Serum melatonin levels were similar between Group I (12.5 ± 2.72 pg/ml) and Group II (10.5 ± 3.73 pg/ml; p > 0,05). The level was significantly lower in Group III (5.72 ± 1.42 pg/ml; p < 0.001). Eradication of H.pylori was obtained in 75.0% women in Group IIIa, and in 84.3% in Group IIIb (p > 0.05). After six months, dyspeptic symptoms resolved in 43.7% patients in Group IIIa and 84.3% in Group IIIb (p < 0.001).

Conclusion: Melatonin supplementation is useful in treating H. pylori-associated dyspepsia, particularly in postmenopausal women with lower levels of this hormone.

Trial registration: NCT04352062, date of registration: 15.04.2020.

Keywords: Dyspepsia; Helicobacter pylori; Melatonin; Menopause.

Conflict of interest statement

The authors declare no conflict of interests. The sponsors had no role in the design, execution, interpretation, or writing of the study.

Figures

Fig. 1
Fig. 1
The serum level of 17-β-estradiol in healthy women (Group I), in women with asymptomatic H. pylori infection (Group II) and in women with both H. pylori infection and chronic dyspepsia (Group III); no significant differences were observed between groups (p > 0.05)
Fig. 2
Fig. 2
The serum level of follicle-stimulating hormone FSH) in healthy women (Group I), in women with asymptomatic H. pylori infection (Group II), and in women with both H.pylori infection and chronic dyspepsia (Group III); no significant differences were found between groups (p > 0.05)
Fig. 3
Fig. 3
The serum level of melatonin in healthy women (Group I), in women with asymptomatic H. pylori infection (Group II), and in women with both H. pylori infection and chronic dyspepsia (Group III); differences between groups I and II (p > 0.05), I and III (p < 0.001), II and III (p < 0.001)
Fig. 4
Fig. 4
Urinary 6-sulfatoxymelatonin excretion in healthy women (Group I), in women with symptomatic H. pylori infection (Group II), and in women with both H. pylori infection and chronic dyspepsia (Group III); differences between all groups are statistically significant (p < 0.001)

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