ArticleThe Journal of clinical endocrinology and metabolism2026
Nocturnal melatonin secretion and risk of type 2 diabetes: a prospective cohort study.
Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
contextMelatonin regulates circadian rhythms and influences glucose metabolism. Altered melatonin secretion may contribute to the pathogenesis of type 2 diabetes (T2D), but prospective population-based evidence is scarce.
objectiveTo examine whether low nocturnal melatonin secretion is associated with an increased risk of incident T2D in adults.
methodsThis prospective cohort study, with follow-up from 2013 to 2023 (median 6.5 years), included a total of 4491 adults (52% women, aged 18-75 years) without T2D and melatonin supplementation at baseline, from the Malmö Offspring Study, a population-based cohort in southern Sweden. Incident T2D was identified via national and regional health registers. Nocturnal melatonin secretion was assessed as the urinary 6-sulfatoxymelatonin-to-creatinine ratio (aMT6s/Cr) from first-morning urine samples, categorized into sex-specific quintiles.
resultsDuring follow-up, 171 participants developed T2D. Participants in the lowest quintile of aMT6s/Cr had a higher T2D risk than those in quintiles 2 to 5 (multivariable adjusted hazard ratio [HR] 1.51, 95% CI 1.09-2.09). The association remained significant after additional adjustment for sleep duration and disruption (HR 1.54, 95% CI 1.11-2.13). When analyzing T2D development per 1-SD higher sex-standardized log aMT6s/Cr, the HR was 0.84 (95% CI 0.73-0.97). Associations were consistent across sex, age, and BMI subgroups.
conclusionLow nocturnal melatonin secretion was independently associated with a higher incidence of T2D in adults. A key limitation is the reliance on a single morning urine sample to estimate melatonin secretion. The findings support circadian regulation as a determinant of metabolic health and warrant further investigation of melatonin pathways in diabetes prevention.
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