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The cytochrome C-based pathway is the primary metabolic pathway for melatonin, and melatonin can be catalysed to form 6-hydroxymelatonin and 6-sulphatoxymelatonin ( 1 -actyl-N 2 -formal-5-methoxykynuramine (AFMK) and N 1 -acetyl-5-methoxykynuramine (AMK) ( 2.3 Uptake, synthesis and degradation of melatonin by mitochondria Melatonin is an amphiphilic molecule which can easily interact with the phospholipid bilayers and directly cross the cell membrane (Wang et al., 2011)

Emphasis has been drawn to studies which recruited larger sample sizes and have reported diagnostic biomarker sensitivities and specificities (whereas many studies have not investigated diagnostic sensitivity or specificity)

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