Therkelsen Kate E, Abraham Tobin M, Pedley Alison, Massaro Joseph M, Sutherland Patrice, Hoffmann Udo, Fox Caroline S
National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA.
Department of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
J Am Heart Assoc. 2016 Feb 23;5(2):e002640. doi: 10.1161/JAHA.115.002640.
Prolactin is an anterior pituitary hormone that may modulate the adverse effects of obesity. Prolactin has been associated with cardiovascular disease mortality, but less is known about whether prolactin predicts incidence of cardiovascular disease risk factors.
Our sample (n=3232, mean age 40.4 years, 52.1% women) was drawn from Framingham Heart Study participants who attended 2 examinations an average of 6.1 years apart. After excluding those with elevated prolactin (>30 mg/dL for women, >20 mg/dL for men), multivariable-adjusted regressions modeled the associations between baseline prolactin and changes in cardiovascular disease risk factors. Models were adjusted for age, sex, baseline value of the risk factor, smoking status, hormone replacement therapy, and menopausal status and additionally for body mass index. Mean prolactin levels were 11.9 mg/dL (SD 5.2) in women and 8.0 mg/dL (SD 2.9) in men. No associations were observed for change in weight, body composition, total cholesterol, triglycerides, or fasting glucose. In women, for example, for each 5-mg/dL increment in prolactin, odds of incident hypercholesterolemia were 1.06, which was not significant (95% CI 0.91-1.23, P=0.46). Some exceptions were of note. In women, for each 5-mg/dL increment in prolactin, we observed increased odds of low high-density lipoprotein cholesterol at follow-up (odds ratio 1.50, 95% CI 1.18-1.91, P=0.001) that persisted after adjustment for body mass index (P=0.001). In men, a 5-mg/dL increment in prolactin was associated with increased odds of incident hypertension (odds ratio 1.61, 95% CI 1.18-2.20 P=0.002) and incident diabetes (odds ratio 1.70, 95% CI 1.04-2.78, P=0.03).
Prolactin is not associated with a comprehensive panel of incident cardiovascular disease risk factors. Measurement of circulating prolactin levels in the community likely does not provide substantial insight into cardiometabolic risk.
催乳素是一种垂体前叶激素，可能会调节肥胖的不良影响。催乳素与心血管疾病死亡率相关，但关于催乳素是否能预测心血管疾病危险因素的发生率，人们了解较少。
我们的样本（n = 3232，平均年龄40.4岁，52.1%为女性）取自弗雷明汉心脏研究的参与者，他们平均间隔6.1年参加了两次检查。在排除催乳素水平升高的人群（女性>30 mg/dL，男性>20 mg/dL）后，多变量调整回归模型模拟了基线催乳素与心血管疾病危险因素变化之间的关联。模型对年龄、性别、危险因素的基线值、吸烟状况、激素替代疗法、绝经状态进行了调整，此外还对体重指数进行了调整。女性的平均催乳素水平为11.9 mg/dL（标准差5.2），男性为8.0 mg/dL（标准差2.9）。未观察到体重、身体成分、总胆固醇、甘油三酯或空腹血糖的变化与催乳素之间存在关联。例如，在女性中，催乳素每增加5 mg/dL，发生高胆固醇血症的几率为1.06，差异无统计学意义（95%置信区间0.91 - 1.23，P = 0.46）。有一些例外情况值得注意。在女性中，催乳素每增加5 mg/dL，我们观察到随访时低密度脂蛋白胆固醇降低的几率增加（比值比1.50，95%置信区间1.18 - 1.91，P = 0.001），在调整体重指数后该结果仍然存在（P = 0.001）。在男性中，催乳素增加5 mg/dL与发生高血压的几率增加（比值比1.61，95%置信区间1.18 - 2.20，P = 0.002）和发生糖尿病的几率增加（比值比1.70，95%置信区间1.04 - 2.78，P = 0.03）相关。
催乳素与一系列心血管疾病危险因素的发生无关。在社区中测量循环催乳素水平可能无法为心血管代谢风险提供实质性的见解。
