Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Am J Cardiol. 2019 Oct 15;124(8):1207-1212. doi: 10.1016/j.amjcard.2019.07.017. Epub 2019 Jul 23.
Premenopausal women with macroprolactinemia are characterized by increased cardiometabolic risk. No previous study has investigated the impact of any lipid-lowering agent on circulating levels of cardiometabolic risk factors in patients with elevated macroprolactin content. We studied 2 groups of women matched for age, body mass index, plasma lipids, and blood pressure: 12 women with macroprolactinemia and 14 women with prolactin levels within the reference range. Because of coexistent isolated hypercholesterolemia, all subjects were then treated with atorvastatin (20 mg daily). Glucose homeostasis markers, plasma lipids, as well as circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and 25-hydroxyvitamin D were measured before entering the study and 6 months later. The treatment arms differed in baseline values of hsCRP and 25-hydroxyvitamin D, as well as in insulin sensitivity. Atorvastatin decreased total and low-density lipoprotein cholesterol levels stronger in women without than in women with macroprolactinemia. In normoprolactinemic women, atorvastatin decreased circulating levels of uric acid, hsCRP, fibrinogen, homocysteine, and increased concentrations of 25-hydroxyvitamin D, whereas in women with macroprolactinemia the drug decreased levels of hsCRP and homocysteine, as well as impaired insulin sensitivity. Both study groups differed in post-treatment insulin sensitivity and post-treatment values of prolactin before polyethylene glycol precipitation, macroprolactin, total cholesterol, low-density lipoprotein cholesterol, glycated hemoglobin, uric acid, hsCRP, fibrinogen, homocysteine, and 25-hydroxyvitamin D. In conclusion, the obtained results suggest that macroprolactinemia may attenuate cardiometabolic effects of atorvastatin.
绝经前妇女的催乳素瘤特征是增加了心血管代谢风险。以前没有研究调查过任何降脂药物对高催乳素含量患者循环中心血管代谢危险因素水平的影响。我们研究了两组年龄、体重指数、血浆脂质和血压匹配的女性：12 名催乳素瘤患者和 14 名催乳素水平在参考范围内的女性。由于存在共存的孤立性高胆固醇血症，所有患者随后均接受阿托伐他汀（20 mg 每日）治疗。葡萄糖稳态标志物、血浆脂质以及尿酸、高敏 C 反应蛋白（hsCRP）、纤维蛋白原、同型半胱氨酸和 25-羟维生素 D 的循环水平在进入研究前和 6 个月后进行了测量。治疗组在 hsCRP 和 25-羟维生素 D 的基线值以及胰岛素敏感性方面存在差异。阿托伐他汀在无催乳素瘤的女性中降低总胆固醇和低密度脂蛋白胆固醇的作用强于催乳素瘤的女性。在正常催乳素血症的女性中，阿托伐他汀降低了尿酸、hsCRP、纤维蛋白原、同型半胱氨酸的循环水平，并增加了 25-羟维生素 D 的浓度，而在催乳素瘤的女性中，该药物降低了 hsCRP 和同型半胱氨酸的水平，并且损害了胰岛素敏感性。两组患者在治疗后的胰岛素敏感性和聚乙二醇沉淀后催乳素的治疗后值、催乳素、总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、尿酸、hsCRP、纤维蛋白原、同型半胱氨酸和 25-羟维生素 D 方面存在差异。总之，研究结果表明，催乳素瘤可能会减弱阿托伐他汀的心血管代谢作用。
