Soto-Pedre Enrique, Newey Paul J, Bevan John S, Leese Graham P
Division of Molecular and Clinical MedicineSchool of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
Division of Molecular and Clinical MedicineSchool of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
Endocr Connect. 2017 Nov;6(8):580-588. doi: 10.1530/EC-17-0171.
High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.
A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Record-linkage technology was used to identify patients with hyperprolactinaemia that were compared to an age-sex-matched cohort of patients free of hyperprolactinaemia. The number of deaths and incident admissions with diabetes mellitus, cardiovascular disease, cancer, breast cancer, bone fractures and infectious conditions were compared by the survival analysis.
Patients with hyperprolactinaemia related to pituitary tumours had no increased risk of diabetes, cardiovascular disease, bone fractures, all-cause cancer or breast cancer. Whilst no increased mortality was observed in patients with pituitary microadenomas (HR = 1.65, 95% CI: 0.79-3.44), other subgroups including those with pituitary macroadenomas and drug-induced and idiopathic hyperprolactinaemia demonstrated an increased risk of death. Individuals with drug-induced hyperprolactinaemia also demonstrated increased risks of diabetes, cardiovascular disease, infectious disease and bone fracture. However, these increased risks were not associated with the degree of serum prolactin elevation ( > 0.3). No increased risk of cancer was observed in any subgroup.
No excess morbidity was observed in patients with raised prolactin due to pituitary tumours. Although the increased morbidity and mortality associated with defined patient subgroups are unlikely to be directly related to the elevation in serum prolactin, hyperprolactinaemia might act as a biomarker for the presence of some increased disease risk in these patients.
在部分但并非所有研究中，高血清催乳素浓度都与不良健康结局相关。本研究旨在探讨高催乳素血症相关的发病率和全因死亡率。
在英国苏格兰泰赛德地区进行了一项基于人群的匹配队列研究，时间跨度为1988年至2014年。采用记录链接技术识别高催乳素血症患者，并与年龄、性别匹配的无高催乳素血症患者队列进行比较。通过生存分析比较糖尿病、心血管疾病、癌症、乳腺癌、骨折和感染性疾病的死亡人数和发病入院人数。
与垂体肿瘤相关的高催乳素血症患者患糖尿病、心血管疾病、骨折、全因癌症或乳腺癌的风险并未增加。虽然垂体微腺瘤患者未观察到死亡率增加（风险比=1.65，95%置信区间：0.79-3.44），但其他亚组，包括垂体大腺瘤患者以及药物性和特发性高催乳素血症患者的死亡风险增加。药物性高催乳素血症患者患糖尿病、心血管疾病、感染性疾病和骨折的风险也增加。然而，这些增加的风险与血清催乳素升高程度（>0.3）无关。在任何亚组中均未观察到癌症风险增加。
垂体肿瘤导致催乳素升高的患者未观察到额外的发病率。虽然与特定患者亚组相关的发病率和死亡率增加不太可能直接与血清催乳素升高有关，但高催乳素血症可能是这些患者中某些疾病风险增加的生物标志物。
