The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic
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ORIGINAL ARTICLE
The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic Tolga İnce1 · Hakkı Akman2 · Dilek Çimrin3 · Adem Aydın1 Received: 22 December 2016 / Revised: 13 September 2017 / Accepted: 17 September 2017 © Children’s Hospital, Zhejiang University School of Medicine 2018
Abstract Background Despite the high prevalence of infantile colic, the pathogenesis remains incompletely understood. Cortisol and melatonin hormones affect gastrointestinal system development in several ways, and interestingly, both cortisol and melatonin’s circadian rhythms begin around the 3rd month in which infantile colic symptoms start to decrease. We hypothesized that infantile colic might associate with desynchronization of normal circadian rhythms of these hormones. In this study, we aimed to investigate the role of melatonin and cortisol in the pathogenesis of infantile colic. Methods Patients who were diagnosed as infantile colic according to Wessel’s “rule of three” were enrolled in the colic group. We measured the saliva melatonin and cortisol levels of colic group and control group infants. In both groups, the saliva samples were taken in mornings and at evenings, at the time of diagnosis and 6th month. Results Fifty-five infants finished the study. Melatonin circadian rhythm developed earlier in the control group than the infantile colic group in our study. We found no significant difference between the daily mean cortisol levels. However, infants with colic had flatter daily cortisol slope than controls which pointed out the probability that they had a less clearly defined cortisol rhythm than infants without colic. Conclusions We found an association between melatonin levels and infantile colic. However, more research is needed to fully understand the role of hypothalamic–pituitary–adrenal axis and hormone’s role on infantile colic physiopathology. Keywords Children · Circadian rhythm · Cortisol · Infantile colic · Melatonin
Introduction Infantile colic (IC) is a syndrome of an infant who suffers from crying for 3 hours or more per day, for three or more days per week, and for three consecutive weeks according to Wessel’s classical definition [1]. It is one of the most common problems during infancy, and prevalence ranges from 8 to 40% depending on the diagnostic methodology [2–4]. Colic symptoms tend to occur in the late afternoon and evening and usually start during the 2nd week of life. The characteristic symptomatic peak occurs at the 6th week. It * Adem Aydın [email protected] 1
Department of Pediatrics Social Pediatrics Unit, Faculty of Medicine, Dokuz Eylül University, 35340 Izmir, Turkey
2
Department of Pediatrics, Faculty of Medicine, Dokuz Eylül University, 35340 Izmir, Turkey
3
Department of Biochemistry, Faculty of Medicine, Dokuz Eylül University, 35340 Izmir, Turkey
always dramatically decreases or ends in infants by 3 months of age [4–6]. Although IC is found to be related with several factors in different studies such as inadequate or inapprop
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