Increased melatonin signaling is a risk factor for type 2 diabetes
Open accessAbstract
Type 2 diabetes (T2D) is a global pandemic. Genome-wide association studies (GWASs) have identified >100 genetic variants associated with the disease, including a common variant in the melatonin receptor 1 b gene (MTNR1B). Here, we demonstrate increased MTNR1B expression in human islets from risk G-allele carriers, which likely leads to a reduction in insulin release, increasing T2D risk. Accordingly, in insulin-secreting cells, melatonin reduced cAMP levels, and MTNR1B overexpression exaggerated the inhibition of insulin release exerted by melatonin. Conversely, mice with a disruption of the receptor secreted more insulin. Melatonin treatment in a human recall-by-genotype study reduced insulin secretion and raised glucose levels more extensively in risk G-allele carriers. Thus, our data support a model where enhanced melatonin signaling in islets reduces insulin secretion, leading to hyperglycemia and greater future risk of T2D. The findings also imply that melatonin physiologically serves to inhibit nocturnal insulin release.
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The MTNR1B risk variant rs10830963 confers increased expression of the melatonin receptor in human pancreatic islets.
“The MTNR1B risk variant rs10830963 has a strong association with fasting glucose and confers increased expression of the melatonin receptor in human pancreatic islets (11).”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
The melatonin receptor is a G-protein-coupled receptor that mainly acts by interfering with cAMP formation through inhibitory G proteins, inhibiting adenylate cyclase and subsequently inhibiting insulin release.
“This melatonin receptor is a G-protein-coupled receptor that mainly acts via interfering with the formation of cAMP through inhibitory G proteins, inhibiting adenylate cyclase and subsequently inhibiting insulin release (11).”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
The MTNR1B risk variant rs10830963 has a strong association with fasting glucose.
“The MTNR1B risk variant rs10830963 has a strong association with fasting glucose and confers increased expression of the melatonin receptor in human pancreatic islets (11).”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
The impairment of glucose tolerance and decrease in insulin secretion during late dinner timing might be partly due to the 3.5-fold higher melatonin concentrations.
“This difference might be partly due to the 3.5-fold higher melatonin concentrations, as supported by our earlier trial in which acute melatonin administration impaired glucose tolerance and in vitro b-cell experiments showing decreased insulin secretion due to melatonin (10,11,18,28).”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
MTNR1B overexpression augmented the inhibition of insulin release exerted by melatonin.
“results shown in insulin-secreting cells (11) that demonstrated that MTNR1B overexpression augmented the inhibition of insulin release exerted by melatonin.”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
Melatonin contributes to impaired glucose homeostasis by inhibiting insulin secretion.
“Thus, our study supports the hypothesis that melatonin contributes to impaired glucose homeostasis by inhibiting insulin secretion”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
Previous studies have shown that the association with fasting glucose during the day (typically morning) is robust and reproducible.
“Furthermore, while previous studies have shown that the association with fasting glucose during the day (typically morning) is robust and reproducible (11)”
From Interplay of Dinner Timing and <i>MTNR1B</i> Type 2 Diabetes Risk Variant on Glucose Tolerance and Insulin Secretion: A Randomized Crossover Trial (2022) · cites this paper as [11]
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BackgroundMembrane Melatonin Receptors Activated Cell Signaling in Physiology and Disease
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Circadian blueprint of metabolic pathways in the brain
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Circadian desynchrony and glucose metabolism
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“177 However, randomized controlled trials in humans found no effect of melatonin supplementation on glucose ‐ stimulated insulin secretion, 178 but a decreased insulin sensitivity index in healthy men upon a high daytime dose of melatonin, 179 and reduced whole ‐ body insulin sensitivity after 3…”
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“It has been shown that disturbance of melatonin signaling is implicated in development of T2DM raised by IR [39-42].”
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“The SNP rs10830963, which is one of the strongest eQTLs for the melatonin receptor 1B gene (MTNR1B) in human islets (30) was nominally associated with CIR (G allele, b =20.”
BackgroundRole of the Circadian Clock in the Metabolic Syndrome and Nonalcoholic Fatty Liver Disease
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“the risk of developing diabetes among those carrying the MNTR1B risk allele [28, 29, 138, 165].”
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New insights into the role of melatonin in plants and animals
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Melatonin, mitochondria, and the metabolic syndrome
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“Melatonin treatment reduced insulin secretion and raised glucose levels more extensively in risk G-allele carriers, indicating that an increased melatonin signaling may be a risk factor for type 2 diabetes [157].”
Gestational Diabetes Mellitus: Mechanisms Underlying Maternal and Fetal Complications
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“Overexpression of MTN-R1B in insulin-secreting β-cells significantly enhances the in - hibitory effect of melatonin on insulin release, primarily by reducing cyclic adenosine monophosphate levels, a critical signaling molecule for insulin secretion [55].”
Serotonergic regulation of insulin secretion
Cataldo, L. R., Lyons, C., Bennet, H., Artner, I., & Fex, M. (2018) · Acta Physiologica · doi:10.1111/apha.13101 · Cited by 64 · see citing works
Continuous Alertness Assessments
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“While a biological rhythm, which is chronically out of sync, can cause serious health problems [18, 65], time-of-day variations have a significant impact on our everyday cognitive performance [56] affecting alertness and fatigue levels.”
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“Functional studies on the common SNP rs10830963, located in the intron of MTNR1B, showed a twofold increase in MTNR1B mRNA abundance in human pancreatic islets of GG T2D risk allele carriers (9).”
BackgroundPoor Quality Control of Over-the-Counter Melatonin: What They Say Is Often Not What You Get
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“16,17 Melatonin appears to inhibit nocturnal insulin release, 18 and long-term use of prolonged-release melatonin in patients with type 2 diabetes mellitus had a beneficial effect on their hemoglobin A1c levels.”
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Carbamate Insecticides Target Human Melatonin Receptors
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The Biological Clock: A Pivotal Hub in Non-alcoholic Fatty Liver Disease Pathogenesis
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“…response of energy expenditure to weight-loss diets (measured as respiratory quotient and resting metabolic rate) in carriers of CRY2 rs11605924 variant as well as rs10830963G allele of MTNR1B gene, encoding the MT2 melatonin receptor (Mirzaei et al., 2014; Lane et al., 2016; Tuomi et al., 2016).”
BackgroundDiabetes mellitus and melatonin: Where are we?
Patel, R., PARMAR, N. R., Palit, S. P., RATHWA, N. N., Ramachandran, A. V., & Begum, R. (2022) · Biochimie · doi:10.1016/j.biochi.2022.01.001 · Cited by 58 · see citing works
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“Indeed, increased expression of MTNR1B in human -cells attenuates GSIS consistent with acute effects of melatonin on reducing cAMP levels and potential physiological role in restraining nighttime insulin release (52, 53).”
BackgroundGubin, D. G., Nelaeva, A. A., Uzhakova, A. E., Хасанова, Ю. В., Cornélissen, G., & Weinert, D. (2017) · Chronobiology International · doi:10.1080/07420528.2017.1347670 · Cited by 54 · see citing works
“Genetic polymorphismmay be particularly important as some patients may be predisposed to have a pancreas that is sensitive to insulin-inhibiting effects of nocturnal melatonin (Tuomi et al., 2016).”
BackgroundPleiotropic Effects of Melatonin
Mahmood, D. (2019) · Drug Research · doi:10.1055/a-0656-6643 · Cited by 52 · see citing works
“, also suggested that melatonin physiologically could inhibit insulin release during the nighttime.[68] Previously, McMullan et al.”
BackgroundHu, S., Hu, C., Luo, L., Zhang, H., Zhao, S., Liu, Z., & Zeng, L. (2022) · Food Chemistry · doi:10.1016/j.foodchem.2022.133500 · Cited by 46 · see citing works
Human Pluripotent Stem Cells to Model Islet Defects in Diabetes
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“A genetic variant increasing the expression of MTNR1B has been shown to lower cAMP levels in beta cells, leading to reduced insulin secretion (68).”
BackgroundPace, N. P., Vassallo, J., & Calleja‐Agius, J. (2020) · Early Human Development · doi:10.1016/j.earlhumdev.2020.105219 · Cited by 45 · see citing works
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Melatonin Uptake by Cells: An Answer to Its Relationship with Glucose?
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“However, whether this is due as has been suggested to an excess of melatonin signaling [175] or rather, on the contrary, to a defective receptor function is still a matter of debate [176].”
BackgroundAssociations between chronotype, MTNR1B genotype and risk of type 2 diabetes in UK Biobank
Tan, X. W., Ciuculete, D. M., Schiöth, H. B., & Benedict, C. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12994 · Cited by 41 · see citing works
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“thesis; cAMP is a stimulator of insulin release [18].”
BackgroundFrom Genetic Association to Molecular Mechanisms for Islet-cell Dysfunction in Type 2 Diabetes
Mattis, K. K., & Gloyn, A. L. (2020) · Journal of Molecular Biology · doi:10.1016/j.jmb.2019.12.045 · Cited by 39 · see citing works
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“In addition, protocols providing exogenous melatonin have found decreases in insulin secretion and sensitivity (56, 57), and individuals carrying a common variant in the melatonin receptor 1b gene have increased risk for impaired glucose regulation (58, 59), further supporting the hypothesis relating the circadian tim…”
BackgroundSkawratananond, S., Xiong, D. X., Zhang, C., Tonk, S. S., Pinili, A., Delacruz, B., Pham, P., Smith, S. C., Navab, R., & Reddy, P. H. (2025) · Ageing Research Reviews · doi:10.1016/j.arr.2025.102732 · Cited by 39 · see citing works
Untimely oxidative stress in β-cells leads to diabetes – Role of circadian clock in β-cell function
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Lined multifocal wearers prefer progressive addition lenses.
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“Another more recent study reported a decreased hepatic insulin sensitivity and an increased insulin secretion in MT2 KOmice (Tuomi et al., 2016).”
BackgroundQiu, X., Liang, T., Wu, Z., Zhu, Y., Gao, W., Gao, B., Qiu, J., Wang, X., Chen, T., Deng, Z., et al. (2022) · International Journal of Biological Sciences · doi:10.7150/ijbs.65973 · Cited by 34 · see citing works
“Melatonin receptor signaling pathways have been found to be related to several diseases, such as type II diabetes mellitus[52], multiple sclerosis[53] and tumor recurrence[54].”
BackgroundSleep Control, GPCRs, and Glucose Metabolism
Tsuneki, H., Sasaoka, T., & Sakurai, T. (2016) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2016.06.011 · Cited by 34 · see citing works
“An increase in the expression of the MT2 receptor found in the islets of humans with a common diabetes risk variant in MTNR1B (rs10830963) was found to enhance the melatonin-induced inhibition of insulin release in insulin-secreting cells [62].”
BackgroundReutrakul, S., Siwasaranond, N., Nimitphong, H., Saetung, S., Chirakalwasan, N., Chailurkit, L., Srijaruskul, K., Ongphiphadhanakul, B., & Thakkinstian, A. (2017) · Chronobiology International · doi:10.1080/07420528.2016.1278382 · Cited by 33 · see citing works
“However, positive effects of melatonin on glucose metabolism were not unanimous as a recent study revealed that melatonin blocks insulin release in mouse islets and clonal insulin-secreting cells (Tuomi et al., 2016).”
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Building Cognition-Aware Systems
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“Chronically high levels of mental load and circadian disruptions can further lead to depression, burnout, and even diabetes [31].”
BackgroundMelatonin signalling and type 2 diabetes risk: too little, too much or just right?
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Association of melatonin & MTNR1B variants with type 2 diabetes in Gujarat population
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A new prospective on the role of melatonin in diabetes and its complications
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Melatonin in energy control: Circadian time‐giver and homeostatic monitor
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“99 Temporal mismatches between the nocturnal secretion of pineal melatonin and the daily feeding/fasting cycle may have deleterious effects on human glycemic control.”
BackgroundWhat do we really know about the safety and efficacy of melatonin for sleep disorders?
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“These findings are underpinned by the effects of a gain of function mutation (BG allele^) of the melatonin receptor gene MTNR1B, which is prodiabetic, after overexpression in pancreatic beta cells [66, 67].”
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“Studies have revealed that the rs10830963G allele greatly enhances the expression of MT2 [58,60–62], with NEUROD1 and FOXA2 [22,63] serving as two important transcription factors in this process.”
BackgroundInfluentialThe case for too little melatonin signalling in increased diabetes risk
Bonnefond, A., & Froguel, P. (2017) · Diabetologia · doi:10.1007/s00125-017-4255-x · Cited by 28 · see citing works
Li‐Gao, R., Hughes, D. A., van Klinken, J. B., de Mutsert, R., Rosendaal, F. R., Mook-Kanamori, D. O., Timpson, N. J., & van Dijk, K. W. (2021) · Diabetes · doi:10.2337/db21-0397 · Cited by 28 · see citing works
“The G-allele carriers exhibited a stronger inhibition of insulin secretion after melatonin treatment (43).”
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Circadian Clock-Controlled Checkpoints in the Pathogenesis of Complex Disease
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Distribution and density of melatonin receptors in human main pancreatic islet cell types
Zibolka, J., Bazwinsky‐Wutschke, I., Mühlbauer, E., & Peschke, E. (2018) · Journal of Pineal Research · doi:10.1111/jpi.12480 · Cited by 27 · see citing works
Pancreatic Islet Transcriptional Enhancers and Diabetes
Cebola, I. (2019) · Current Diabetes Reports · doi:10.1007/s11892-019-1230-6 · Cited by 25 · see citing works
A Wake-up Call for Type 2 Diabetes?
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- Authors
- Tuomi, T., Nagorny, C. L. F., Singh, P., Bennet, H., Yu, Q., Alenkvist, I., Isomaa, B., Östman, B., Söderström, J., Pesonen, A.-K., Martikainen, S., Räikkönen, K., Forsén, T., Hakaste, L., Almgren, P., Storm, P., Asplund, O., Shcherbina, L., Fex, M., Fadista, J., Tengholm, A., Wierup, N., Groop, L., & Mulder, H.
- Affiliations
- Lund University (SE)
- Uppsala University (SE)
- University of Helsinki (FI)
- Folkhälsans Forskningscentrum (FI)
- Corresponding author
- Mulder, Hindrik
- ORCID
- Venue
- Cell Metabolism
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 23
- Issue
- 6
- Pages
- 1067-1077
- ISSN
- 1550-4131 (ISSN-L)
- OpenAlex
- W2367683267
- Cited by
- 262
- References
- 44
- Citations by year
- 2026: 17 · 2025: 27 · 2024: 20 · 2023: 17 · 2022: 17 · 2021: 28 · 2020: 29 · 2019: 27 · 2018: 36 · 2017: 30 · 2016: 13
- FWCI
- 39.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion, other-oa)
- Työväentutkimus Vuosikirja (submittedVersion, other-oa)
- Funders
- Helsingin ja Uudenmaan Sairaanhoitopiiri
- Finska Läkaresällskapet
- Folkhälsanin Tutkimussäätiö
- European Foundation for the Study of Diabetes
- Lunds Universitet (2009-1039)
- Novo Nordisk
- Signe ja Ane Gyllenbergin Säätiö
- Vetenskapsrådet (349-2006-237, 325‐2012‐6778, 2010-03490, 521-2012-2119, 2006–237, 2009-1039, 521-2010-3490)
- Samfundet Folkhälsan
- Sigrid Juséliuksen Säätiö
- Svenska Kulturfonden
- Paavo Nurmen Säätiö
- Novo Nordisk Fonden (NNF14OC0010995, NNF14OC0010363)
- Diabetestutkimussäätiö
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 2 diabetes, melatonin signaling, MTNR1B, insulin secretion, pancreatic islets, cyclic AMP, genetic risk variants, hyperglycemia, melatonin treatment
- MeSH terms
- Insulin Secretion, Cyclic AMP, Animals, Diabetes Mellitus, Type 2, Glucose, Heterozygote, Humans, Insulin, Melatonin, Risk Factors, Signal Transduction, Mice, Knockout, Genetic Predisposition to Disease, Polymorphism, Single Nucleotide, Quantitative Trait Loci, Receptors, Melatonin, Insulin-Secreting Cells
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