Special peculiarities of clinical course of osteoarthrosis of knee joints depending on 6-hydroxymelatonin-sulfate urinary excretion profile


knee joint


The study objective was to define the special features of the clinical course of knee joint osteoarthrosis depending on 6-sulfatoxymelatonin urinaryexcretion profile.Materials and methods.We surveyed 141 patients with radiological Stage II-III osteoarthrosis (OA) of the knee joints (18 female subjects). Diagnosis of OA was established on the basis of ACR criteria (1991) and EULAR (2010) recommendations. We determined the AO clinical indexes (Lequesne, WOMAC, KOOS), HAQ functional index, sleep quality and psycho-emotional state indicators. ELISA was used to assess 6-sulfatoxymelatonin urinary excretion profile.Results. It was established that 66% of patients with OA of knee joints had a reduced 6-sulfatoxymelatonin urinary excretion compared to this of practically healthy individuals. AO patients with low 6-SMT urinary excretion profiles had higher incidence of severe insomnia and depressive disorders. Reduction in 6-SMT excretion was associated with a moderate increase in pain syndrome and deterioration of physical functions by Lequesne, WOMAC, KOOS, and HAQ indexes.Conclusion.The reducedmelatonin production in ОА patients is a factor of more severe clinical course of the disease due to deterioration of the psycho-emotional state, the development of pain syndrome, and functional disorders.


Veyn AM, Levyn YaY. Principles of modern pharmacotherapy of insomnia. Zhurnal nevrologii i psykhiatrii. 1998; 5: 39-43.

Farshatova ER, Kamylov FKh, Enykeev DA, Khalykov AA. Clinical and biochemical evaluation of the melatonin use in the therapy of primary deforming osteoarthritis in women on a background of depression. Meditsynskiy vestnik Bashkortostana. 2009; 4(2): 58-61.

Kolyadenko SV, Stanislavchuk MA. Melatonin profile and levels of IL-8 and IL-10 in patients with fibromyalgia. Ukr. revmatol.zhurn. 2006; 1 (23): 65-68.

Kornienko SM. Interrelation of melatonin with quality of life and personal properties of patients with endometrial pathology in the late reproductive and premenopausal period. Zaporozhskiy meditsynskii zhurnal. 2017; 4(103): 472-475. 2017.4.105103 DOI: https://doi.org/10.14739/2310-1210

Altman RD. Criteria for the classification of clinical osteoarthritis. J.Rheumatology. 1991; 18 (Suppl. 27): 10-12.

Beck AT, Ward CH, Mendelson M. [et al.] An Inventory for measuring depression. Archives of general psychiatry. 1961; 4(6): 561-571. DOI: https://doi.org/10.1001/archpsyc.1961.01710120031004

Saksvik-Lehouillier I, Harrison SL, Marshall LM. [et al.] Association of urinary 6-sulfatoxymelatonin (aMT6s) levels and objective and subjective sleep measures in older men: The MrOS Sleep Study. J. Gerontol. A. Biol.Sci. Med. Sci. 2015; 70 (12): 1569-1577. DOI: https://doi.org/10.1093/gerona/glv088

Bruce B, Fries JF. The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications. Health and Quality of Life Outcomes. 2003; 1: 20. DOI: https://doi.org/10.1186/1477-7525-1-20 [PMid:12831398 PMCid:PMC165587]

Smith MT, Finan PH, Buenaver LF. [et al.] Cognitive-behavioral therapy for insomnia in knee osteoarthritis: a randomized, double-blind, active placebo-controlled clinical trial. Arthritis Rheumatol. 2015; 67 (5): 1221-1233. DOI: https://doi.org/10.1002/art.39048

Lawrence RC, Felson DT, Helmick CG. [et al.] Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008; 58 (1): 26-35. DOI: https://doi.org/10.1002/art.23176

Zhang W, Doherty M, Peat G. [et al.] EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann. Rheum. Dis. 2010; 69 (3): 483-489. DOI: https://doi.org/10.1136/ard.2009.113100

Hardeland R. Neurobiology, pathophysiology, and treatment of melatonin deficiency and dysfunction. Scientific World Journal. 2012; 2012: 640389. DOI: https://doi.org/10.1100/2012/640389

Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14 (6): 540-545. DOI: https://doi.org/10.1093/sleep/14.6.540 [PMid:1798888]

Roos EM, Roos HP, Lohmander LS. [et al.] Knee Injury and Osteoarthritis Outcome Score (KOOS) - development of a self-administered outcome measure. J. Orthop. Sports. Phys. Ther. 1998; 28(2): 88-96. DOI: https://doi.org/10.2519/jospt.1998.28.2.88 [PMid:9699158]

Lequesne MG. The algofunctional indices for hip and knee osteoarthritis. J. Rheumatol. 1997; 24 (4): 779-781. [PMid:9101517]

Loeser RF, Collins JA, Diekman BO. Ageing and the pathogenesis of osteoarthritis. Nature reviews Rheumatology. 2016; 12 (7): 412-420. DOI: https://doi.org/10.1038/nrrheum.2016.65

Guo JY, Li F, Wen YB. [et al.] Melatonin inhibits Sirt1-dependent NAMPT and NFAT5 signaling in chondrocytes to attenuate osteoarthritis. Oncotarget. 2017; 8 (34): 55967-55983. DOI: https://doi.org/10.18632/oncotarget.18356

Jenwitheesuk A, Nopparat C, Mukda S. [et al.] Melatonin regulates aging and neurodegeneration through energy metabolism, epigenetics, autophagy and circadian rhythm pathways. Int. J. Mol. Sci. 2014; 15 (9): 16848-16884. DOI: https://doi.org/10.3390/ijms150916848

Parmelee PA, Tighe CA, Dautovich ND. Sleep disturbance in osteoarthritis: linkages with pain, disability and depressive symptoms. Arthritis Care & Research. 2015; 67(3): 358-365. DOI: https://doi.org/10.1002/acr.22459

Snelling SJ, Forster A, Mukherjee S. [et al.] The chondrocyte-intrinsic circadian clock is disrupted in human osteoarthritis. Chronobiol. Int. 2016; 33(5): 574-579. DOI: https://doi.org/10.3109/07420528.2016.1158183

Markey SP, Higa S, Shih M. [et al.] The correlation between human plasma melatonin levels and urinary 6-hydroxymelatonin excretion. Clin. Chim. Acta. 1985; 150 (3): 221-225. DOI: https://doi.org/10.1016/0009-8981(85)90247-5

Bellamy N, Buchanan W, Goldsmith C. [et al.]Validation study of WOMAC: A Health Status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J. Rheumatol. 1988;15(12): 1833-1840. [PMid:3068365]

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Download data is not yet available.