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[高催乳素血症与骨矿物质密度]

[Hyperprolactinaemia and bone mineral density].

作者信息

Kostrzak Anna, Męczekalski Błażej

机构信息

Department of Gynecological Endocrinology, Medical University of Poznań, Poland.

出版信息

Pol Merkur Lekarski. 2015 Aug;39(230):122-5.

Abstract

Hyperprolactinaemia is one of the most common endocrinological disorder at women at the reproductive age. Prolactin is produced by the anterior lobe of the pituitary.The main role of prolactin is associated with mamotrophic action and lactogenesis. Hyperprolactinaemia causes several symptoms such as menstrual disorders, infertility, decrease of sexual function, galactorrhea in women and gynecomasty, impotence and decrease of semen quality in men. Recent studies have presented prolactin as a homone involved in many metabolic processes. Long-term consequences of high prolactin serum concentration are related to higher risk of cardiovascular system disease, disturbances in lipid profile and immunological system. Hyperprolactiaemia causes decrease of bone mass density (BMD). High serum prolactin levels lead to increase of the risk of osteopenia or/and osteoporosis. Decrease of BMD results from hypoestrogenism induced by hyperprolactinaemia and also by the direct negative influence of prolactin on bone. Hyperprolactinaemia related to prolactinoma significantly (more than functional hyperprolactiaemia) increases the risk of osteopenia, osteoporosis and bone fractures. Important group of patients threatened by osteoporosis and bone fracture is constituted by women which use antipsychotic drugs (which induce hyperprolactinaemia). Hyperprolactinaemia diagnosed in patients should be treated as soon as possible. Hyperprolactinaemic patients should be diagnosed in the direction of osteopenia and osteoporosis. When diagnosis is confirmed proper treatment is indicated.

摘要

高催乳素血症是育龄期女性最常见的内分泌疾病之一。催乳素由垂体前叶分泌。催乳素的主要作用与乳腺营养作用和泌乳生成有关。高催乳素血症会引发多种症状,如女性月经紊乱、不孕、性功能减退、溢乳,男性乳房增生、阳痿和精液质量下降。最近的研究表明催乳素是一种参与多种代谢过程的激素。血清催乳素浓度长期处于高位会增加患心血管系统疾病、脂质代谢紊乱和免疫系统疾病的风险。高催乳素血症会导致骨密度降低(BMD)。血清催乳素水平升高会增加患骨质减少或/和骨质疏松症的风险。骨密度降低是由高催乳素血症诱导的雌激素缺乏以及催乳素对骨骼的直接负面影响所致。与催乳素瘤相关的高催乳素血症(比功能性高催乳素血症更显著)会显著增加患骨质减少、骨质疏松症和骨折的风险。使用抗精神病药物(会诱发高催乳素血症)的女性构成了受骨质疏松症和骨折威胁的重要患者群体。确诊为高催乳素血症的患者应尽快接受治疗。对于高催乳素血症患者,应朝着骨质减少和骨质疏松症的方向进行诊断。确诊后应进行适当的治疗。

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