Glaucoma may be associated with circadian disruption due to its association with a loss of intrinsically photosensitive retinal ganglion cells. Clinical evidence demonstrating an association between glaucoma and circadian disruption is limited, and no large‐scale studies have been performed. The purpose of this cross‐sectional study was to determine whether the presence and severity of glaucoma is correlated with the urinary 6‐sulfatoxymelatonin levels as a circadian rhythm parameter. We measured the level of urinary 6‐sulfatoxymelatonin excretion (UME) in 118 glaucoma patients and 395 control participants without glaucoma. The UME in the glaucoma group was significantly lower than that of the control group without glaucoma (3.05 and 3.24 log ng/mg creatinine, respectively; P  = .010). Next, we examined association of the severity of glaucoma and melatonin levels. In stratification analysis of the glaucoma groups, multivariable linear regression analyses adjusted for potential confounders indicated significantly lower UME by 0.30 log ng/mg creatinine in patients with functional severe glaucoma (visual field mean deviation ≤ −6 dB) compared with mild glaucoma (mean deviation > −6 dB; P  = .040) and lower UME by 0.05 log ng/mg creatinine with each 10 μm thinning of the circumpapillary retinal nerve fiber layer thickness as the index of structural severity of glaucoma (P  = .011). In conclusion, significant association between glaucoma and lower urinary 6‐sulfatoxymelatonin was found. In addition, patients with functional and structural severe glaucoma were significantly associated with lower urinary 6‐sulfatoxymelatonin levels. Our results indicate the possibility of a circadian disruption in patients with glaucoma.

中文翻译：

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青光眼患者褪黑激素分泌减少：LIGHT 研究中与青光眼严重程度的定量关联。

青光眼可能与昼夜节律紊乱有关，因为它与固有光敏视网膜神经节细胞的丧失有关。证明青光眼与昼夜节律紊乱之间关联的临床证据有限，并且尚未进行大规模研究。这项横断面研究的目的是确定青光眼的存在和严重程度是否与作为昼夜节律参数的尿 6-硫酸羟褪黑激素水平相关。我们测量了 118 名青光眼患者和 395 名无青光眼的对照参与者的尿 6-磺基褪黑激素排泄水平 (UME)。青光眼组的 UME 显着低于无青光眼的对照组（分别为 3.05 和 3.24 log ng/mg 肌酐；P = .010）。接下来，我们检查了青光眼严重程度与褪黑激素水平之间的关联。在青光眼组的分层分析中，针对潜在混杂因素调整的多变量线性回归分析表明，与轻度青光眼（平均偏差> −6 dB; P  = .040) 并且将 UME 降低 0.05 log ng/mg 肌酐，每减薄 10 μm 视乳头周围视网膜神经纤维层厚度作为青光眼结构严重程度的指标（P = .011）。总之，发现青光眼与下尿 6-磺基褪黑激素之间存在显着关联。此外，功能性和结构性重度青光眼患者与较低的尿 6-磺基褪黑激素水平显着相关。我们的结果表明青光眼患者可能会出现昼夜节律紊乱。