Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
General Surgery Department & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China.
Endocr Pract. 2021 Jul;27(7):728-735. doi: 10.1016/j.eprac.2021.01.002. Epub 2021 Jan 15.
Prolactin (PRL) is a polypeptide hormone named for its crucial role in lactation. Recently, PRL has been recognized as a metabolic hormone that regulates energy metabolism. The current study aimed to investigate the relationship between circulating PRL and metabolic alterations in overweight/obese patients and the effect of weight loss through bariatric surgery on circulating PRL.
A total of 448 overweight/obese patients aged between 18 and 40 years and 120 age- and sex-matched healthy controls with normal weight were enrolled. Among all participants, 156 obese patients underwent bariatric surgery.
Circulating PRL levels were significantly increased in the overweight (15.27 ± 9.58 μg/L) and obese (17.75 ± 9.15 μg/L) groups compared with the normal weight (13.57 ± 9.03 μg/L) group. Multiple regression analyses demonstrated that the adipose tissue insulin resistance (adipo-IR) level was an independent predictor for PRL (β = -0.451, P < .01). Despite comparable anthropometric parameters, the overweight/obese patients with a higher PRL tertile had decreased levels of triglycerides, nonesterified fatty acids, homeostasis model assessment of insulin resistance, and adipo-IR compared with the patients in the moderate and lower PRL tertiles. Serum PRL levels were significantly decreased following the alleviation of metabolic parameters after bariatric surgery (from 17.12 ± 8.27 to 13.00 ± 5.78 μg/L, P < .05), and the decrease in PRL levels was significantly greater in the lower adipo-IR group than in the higher adipo-IR group (P < .01).
An increased serum PRL level might be an adaptive response for protecting against metabolic disorders in obesity.
催乳素（PRL）是一种多肽激素，因其在哺乳中的关键作用而得名。最近，PRL 被认为是一种调节能量代谢的代谢激素。本研究旨在探讨超重/肥胖患者循环 PRL 与代谢改变的关系，以及减肥手术对循环 PRL 的影响。
共纳入 448 名年龄在 18 至 40 岁之间的超重/肥胖患者和 120 名年龄和性别匹配的正常体重健康对照者。所有参与者中，有 156 名肥胖患者接受了减肥手术。
与正常体重组（13.57 ± 9.03 μg/L）相比，超重组（15.27 ± 9.58 μg/L）和肥胖组（17.75 ± 9.15 μg/L）的循环 PRL 水平显著升高。多元回归分析表明，脂肪组织胰岛素抵抗（adipo-IR）水平是 PRL 的独立预测因子（β=-0.451，P<0.01）。尽管人体测量参数相似，但 PRL 三分位较高的超重/肥胖患者的甘油三酯、非酯化脂肪酸、稳态模型评估的胰岛素抵抗和 adipo-IR 水平较中、低 PRL 三分位患者降低。减肥手术后，代谢参数得到改善，血清 PRL 水平显著下降（从 17.12 ± 8.27 降至 13.00 ± 5.78 μg/L，P<0.05），且低 adipo-IR 组 PRL 水平下降幅度明显大于高 adipo-IR 组（P<0.01）。
血清 PRL 水平升高可能是肥胖患者代谢紊乱的一种适应性反应。
