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Gastroenterology Research and Practice
Volume 2012, Article ID 510764, 7 pages
Clinical Study

Melatonin Levels in Serum and Ascitic Fluid of Patients with Hepatic Encephalopathy

1Department of Gastroenterology, Medical University of Lodz, 1 Haller’s Square, 90-647 Lodz, Poland
2Department of Neuroendocrinology, Medical University of Lodz, 1/3 Sterlinga street, 91-425 Lodz, Poland
3Department of Molecular Genetics, University of Lodz, 141/143 Pomorska street, 90-237 Lodz, Poland

Received 16 August 2012; Accepted 4 December 2012

Academic Editor: Paolo Gionchetti

Copyright © 2012 Cezary Chojnacki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cirrhotic patients exhibit disturbed melatonin homeostasis, which may lead to sleep disturbances, but an influence on the hepatic encephalopathy has not been elucidated. Aim. In the present study, the association of melatonin levels in serum and ascitic fluid and ammonia concentration related to the intensity of hepatic encephalopathy (HE) was investigated. Material and Methods. The study included 90 alcoholic patients with hepatic encephalopathy and 30 healthy volunteers (C). Patients were divided in three groups according to 0–4 West-Haven Score: HE1 ( ), HE2 ( ), and HE3 ( ). Melatonin was measured by radioimmune assay. Results. In fasting patients with hepatic encephalopathy we noted higher melatonin serum levels [pg/mL] than in healthy subjects groups: C—11.3 ± 3.9, HE1 – 34.3 ± 12.2 , HE2—54.8 ± 23.9, and HE3—119.8 ± 96.4 . No correlation between melatonin and ammonia levels was found. Melatonin was detected in ascetic fluid in 24 patients of group HE2 and 27 patients of group HE2 of hepatic encephalopathy. Conclusions. Our results suggest that high blood levels of melatonin in cirrhotic liver patients may account for some of the clinical manifestations of hepatic encephalopathy, for example, daytime sleepiness, fatigue.