Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Endocrine. 2022 Oct;78(1):135-141. doi: 10.1007/s12020-022-03145-1. Epub 2022 Jul 29.
Unlike hyperprolactinemia, clinical significance of prolactin deficiency remains poorly understood. The aim of this study was to assess the cardiometabolic profile of patients with low prolactin levels.
The study population consisted of three groups of young women. Two groups were chronically treated with cabergoline but differed in prolactin levels, which were either abnormally low (group A; n = 16) or within the reference range (group B, n = 23). Group C, serving as a control group, included 28 drug-naïve women with normal prolactin levels. The dose of cabergoline in group A was then tapered down. Glucose homeostasis markers, plasma lipids and circulating levels of hormones, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, as well as the carotid intima-media thickness were assessed at baseline and 6 months later.
Compared with subjects with normal prolactin levels, women with hypoprolactinemia had higher levels of 2-h postchallenge glucose, glycated hemoglobin, triglycerides, uric acid, hsCRP and fibrinogen, lower values of HDL-cholesterol, total testosterone and free androgen index, as well as reduced insulin sensitivity. No differences in these variables were observed between groups B and C. Apart from prolactin normalization, cabergoline dose reduction reversed all laboratory disturbances reported in group A.
The obtained results suggest that hypoprolactinemia in women of reproductive age may increase cardiometabolic risk.
与高催乳素血症不同，催乳素缺乏的临床意义仍知之甚少。本研究旨在评估低催乳素水平患者的心脏代谢特征。
研究人群包括三组年轻女性。两组患者长期接受卡麦角林治疗，但催乳素水平不同，一组催乳素水平异常低（A 组，n=16），另一组催乳素水平在参考范围内（B 组，n=23）。C 组为对照组，包括 28 名未服用药物且催乳素水平正常的女性。然后逐渐减少 A 组的卡麦角林剂量。在基线和 6 个月后评估葡萄糖稳态标志物、血浆脂质和循环激素、尿酸、高敏 C 反应蛋白（hsCRP）、纤维蛋白原和同型半胱氨酸水平以及颈动脉内膜中层厚度。
与催乳素水平正常的受试者相比，催乳素缺乏的女性 2 小时餐后血糖、糖化血红蛋白、甘油三酯、尿酸、hsCRP 和纤维蛋白原水平更高，高密度脂蛋白胆固醇、总睾酮和游离雄激素指数水平更低，胰岛素敏感性降低。B 组和 C 组之间这些变量没有差异。除了催乳素正常化外，卡麦角林剂量减少还逆转了 A 组报告的所有实验室异常。
研究结果表明，生育年龄妇女的低催乳素血症可能会增加心脏代谢风险。
