长期使用褪黑素与心力衰竭风险关联

美国心脏协会发布的初步研究发现，长期使用褪黑素补充剂的慢性失眠患者在五年内心力衰竭风险提高约90%。1这项纳入130,828名成人的研究基于TriNetX全球研究网络的电子医疗记录数据，对65,414名长期使用褪黑素的患者与等数量对照组进行了对比分析。1长期使用褪黑素（12个月或以上）的受试者中，4.6%患者发生了心力衰竭，而对照组仅为2.7%。1

住院和死亡数据进一步凸显了这一风险。1褪黑素使用者的心力衰竭住院率达19.0%，是对照组6.6%的3.5倍；五年期间褪黑素组的死亡率为7.8%，对照组为4.3%，风险接近两倍。1当研究限制在至少填充两次褪黑素处方且间隔至少90天的参与者时，心力衰竭风险仍提高82%。1

研究团队强调这是观察性研究，无法证明因果关系，需要进一步研究予以确认。1研究负责人Ekenedilichukwu Nnadi医生指出："褪黑素补充剂可能不如通常假设的那样无害"。1哥伦比亚大学睡眠研究专家Marie-Pierre St-Onge对医生为失眠患者长期处方褪黑素感到惊讶，因为褪黑素在美国未被指示用于治疗失眠。1

A preliminary study released by the American Heart Association has found that adults with chronic insomnia who use melatonin supplements for extended periods face substantially elevated heart failure risk.1 Researchers analyzing electronic health records from 130,828 adults through the TriNetX global research network discovered that long-term melatonin use—defined as 12 months or longer—was associated with approximately a 90% increased risk of heart failure within five years.1

The study compared 65,414 long-term melatonin users with 65,414 control group participants who did not use the supplement.1 Among melatonin users, 4.6% developed heart failure compared to 2.7% in the control group.1 Hospitalization rates for heart failure were substantially higher in the melatonin group at 19.0% versus 6.6% in controls—more than three times higher.1 Mortality over the five-year period showed a similar pattern, with 7.8% of melatonin users dying compared to 4.3% of non-users, representing nearly double the risk.1 When the analysis was restricted to participants with at least two melatonin prescriptions filled with a minimum 90-day interval between them, the heart failure risk increase was 82%.1

Study director Dr. Ekenedilichukwu Nnadi cautioned that "melatonin supplements may not be as harmless as commonly assumed."1 However, researchers emphasized this is an observational study and cannot prove causation, requiring further investigation to confirm the findings.1 Marie-Pierre St-Onge, a sleep research specialist at Columbia University, expressed surprise at physicians prescribing melatonin long-term for insomnia, noting it is not FDA-indicated for this use in the United States.1