{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:51:36Z","timestamp":1793490696563,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pineal Research"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Thalassemia patients often exhibit low bone mineral density (BMD). The iron overload associated with thalassemia elevates oxidative stress levels, leading to reduced BMD. Melatonin improves BMD in postmenopausal osteopenia, however, its effect on BMD in thalassemia patients with iron overload has not been investigated. A randomized controlled study was conducted at Hematology Clinic, Faculty of Medicine, Chiang Mai University. Thalassemia patients with osteopenia and iron overloaded condition, as indicated by BMD Z\u2010score &lt;\u22122 at\n                    <jats:sc>l<\/jats:sc>\n                    \u2010spine, femoral neck, or total hip, and serum ferritin level &gt;\u2009500\u2009\u03bcg\/L were recruited in this study. Patients were randomized to receive either melatonin 20\u2009mg\/day or placebo at bedtime for 12 months. BMD was re\u2010evaluated 12 months after interventions. Bone turnover markers (BTM), malondialdehyde (MDA as an oxidative stress marker), and pain scores were assessed at baseline, 6, and 12 months. The outcomes, including BMD, BTM, MDA, and pain scores, were evaluated in all patients. Forty\u2010one thalassemia patients (18 males) were enrolled in the study and randomly assigned to either the melatonin group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200921) or the placebo group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920). Characteristics of patients were not differences between groups. Mean age was 30.8\u2009\u00b1\u20096.2 years old. Thirty\u2010three patients (80.4%) were transfusion\u2010dependent patients. At 12 months, mean BMD at\n                    <jats:sc>l<\/jats:sc>\n                    \u2010spine in melatonin group was not significantly different from placebo group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.069). However,\n                    <jats:sc>l<\/jats:sc>\n                    \u2010spine BMD at 12 months in the melatonin group was significantly greater than baseline (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.029). Serum levels of P1NP and MDA were significantly reduced at 6 months compared to baseline following melatonin treatment. The melatonin group experienced a notable decrease in back pain scores after 12 months compared to the initial measurements. 20\u2009mg daily melatonin supplementation for 12 months alleviated\n                    <jats:sc>l<\/jats:sc>\n                    \u2010spine BMD loss in iron\u2010overloaded thalassemia with low BMD. Melatonin also significantly reduced circulating oxidative stress and mitigated back pain in these patients.\n                  <\/jats:p>","DOI":"10.1111\/jpi.70055","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:54:34Z","timestamp":1746579274000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Melatonin Supplementation Alleviates Bone Mineral Density Decline and Circulating Oxidative Stress in Iron\u2010Overloaded Thalassemia Patients"],"prefix":"10.1111","volume":"77","author":[{"given":"Pokpong","family":"Piriyakhuntorn","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2381-9292","authenticated-orcid":false,"given":"Adisak","family":"Tantiworawit","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattabhorn","family":"Phimphilai","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tawika","family":"Kaewchur","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piangrawee","family":"Niprapan","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhumrapee","family":"Srivichit","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Research and Training Center, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"},{"name":"Center of Excellence in Cardiac Electrophysiology Research Chiang Mai University Chiang Mai Thailand"},{"name":"Department of Oral Surgery, Faculty of Dentistry Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nattayaporn","family":"Apaijai","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Research and Training Center, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"},{"name":"Center of Excellence in Cardiac Electrophysiology Research Chiang Mai University Chiang Mai Thailand"},{"name":"Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krekwit","family":"Shinlapawittayatorn","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Research and Training Center, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"},{"name":"Center of Excellence in Cardiac Electrophysiology Research Chiang Mai University Chiang Mai Thailand"},{"name":"Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipon","family":"Chattipakorn","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Research and Training Center, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"},{"name":"Center of Excellence in Cardiac Electrophysiology Research Chiang Mai University Chiang Mai Thailand"},{"name":"Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1677-7052","authenticated-orcid":false,"given":"Siriporn C.","family":"Chattipakorn","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Research and Training Center, Faculty of Medicine Chiang Mai University Chiang Mai Thailand"},{"name":"Center of Excellence in Cardiac Electrophysiology Research Chiang Mai University Chiang Mai Thailand"},{"name":"Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry Chiang Mai University Chiang Mai 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