Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Pharmacol Rep. 2019 Feb;71(1):61-66. doi: 10.1016/j.pharep.2018.09.004. Epub 2018 Sep 6.
Elevated prolactin levels are associated with increased cardiometabolic risk. No previous study has compared the effect of hypolipidemic therapy on plasma levels of lipids and other cardiometabolic risk factors in patients with and without hyperprolactinemia.
The study included three age-, weight-, blood pressure- and lipid-matched groups of premenopausal women: 18 women with untreated hyperprolactinemia, 19 women with bromocriptine-treated hyperprolactinemia and 20 drug-naïve women with normal prolactin levels. Because of concomitant atherogenic dyslipidemia, all patients were treated with fenofibrate (200 mg daily) for 12 weeks. Plasma lipids, glucose homeostasis markers, as well as plasma levels of uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine and fibrinogen were assessed at baseline and at the end of hypolipidemic treatment.
Unlike similar baseline lipid levels, plasma concentrations of the remaining investigated cardiometabolic risk factors were higher in women with elevated prolactin levels than in patients with normal prolactin levels. The impact of fenofibrate on total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels, as well as on uric acid, hsCRP, homocysteine, and fibrinogen was less pronounced in women with untreated hyperprolactinemia than in women with bromocriptine-treated hyperprolactinemia and drug-naïve women with normal prolactin levels.
The results of our study indicate that cardiometabolic effects of fenofibrate depend on plasma prolactin levels.
催乳素水平升高与心血管代谢风险增加有关。以前没有研究比较降脂治疗对高催乳素血症和无高催乳素血症患者的血脂和其他心血管代谢危险因素血浆水平的影响。
该研究纳入了三组年龄、体重、血压和血脂匹配的绝经前妇女:18 名未经治疗的高催乳素血症妇女、19 名溴隐亭治疗的高催乳素血症妇女和 20 名催乳素正常的药物未治疗妇女。由于同时存在动脉粥样硬化性血脂异常,所有患者均接受非诺贝特(200mg/d)治疗 12 周。在基线和降脂治疗结束时评估血浆脂质、葡萄糖稳态标志物以及尿酸、高敏 C 反应蛋白(hsCRP)、同型半胱氨酸和纤维蛋白原的血浆水平。
与相似的基线血脂水平不同,催乳素水平升高的妇女的其余心血管代谢危险因素的血浆浓度高于催乳素正常的患者。与溴隐亭治疗的高催乳素血症妇女和催乳素正常的药物未治疗妇女相比,非诺贝特对总胆固醇、LDL 胆固醇、HDL 胆固醇和甘油三酯水平以及尿酸、hsCRP、同型半胱氨酸和纤维蛋白原的影响在未经治疗的高催乳素血症妇女中不那么明显。
我们的研究结果表明,非诺贝特的心血管代谢作用取决于血浆催乳素水平。