Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Pharmacology. 2023;108(3):238-244. doi: 10.1159/000528542. Epub 2023 Feb 3.
Metformin was found to reduce elevated levels of anterior pituitary hormones. Its thyrotropin-lowering effect was more pronounced in individuals receiving myo-inositol. The aim of the present study was to investigate whether the concomitant supplementation of myo-inositol determines the impact of metformin on prolactin levels.
The study population consisted of two groups of women with mild-to-moderate hyperprolactinemia. Group 1 included 24 individuals receiving myo-inositol preparations (2 g daily for at least 6 months), while 24 inositol-naïve women belonged to group 2. Both groups were matched for age, insulin sensitivity, and prolactin concentration. For the following 6 months, all women were treated with metformin (1.7 daily). Plasma glucose levels, the homeostatic model assessment of insulin resistance ratio (HOMA-IR), glycated hemoglobin, as well as plasma levels of total prolactin, monomeric prolactin, thyrotropin, free thyroid hormones, adrenocorticotropic hormone, and insulin-like growth factor-1 were measured at baseline and after 6 months of metformin treatment.
Metformin reduced plasma glucose, HOMA-IR, and glycated hemoglobin in both study groups, but this effect was more pronounced in group 1 than group 2. Treatment-induced changes in total and monomeric prolactin levels were significant only in group 1. There were no differences between follow-up and baseline values of thyrotropin, free thyroxine, free tri-iodothyronine, adrenocorticotropic hormone, and insulin-like growth factor-1. Treatment-induced changes in prolactin concentration correlated with baseline prolactin levels, baseline values of HOMA-IR, and the impact of treatment on HOMA-IR.
The obtained results suggest that myo-inositol supplementation potentiates the inhibitory effect of metformin on prolactin levels in women with hyperprolactinemia.
二甲双胍被发现可降低前垂体激素水平升高。在接受肌醇治疗的个体中,其促甲状腺激素降低作用更为明显。本研究的目的是研究肌醇的同时补充是否会影响二甲双胍对催乳素水平的影响。
研究人群由两组轻度至中度高催乳素血症的女性组成。第 1 组包括 24 名接受肌醇制剂治疗的个体(每天 2 克,至少治疗 6 个月),而 24 名未接受肌醇治疗的个体属于第 2 组。两组在年龄、胰岛素敏感性和催乳素浓度方面相匹配。在接下来的 6 个月中,所有女性均接受二甲双胍(每天 1.7 克)治疗。在基线和接受二甲双胍治疗 6 个月后,测量血浆葡萄糖水平、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白以及总催乳素、单体催乳素、促甲状腺激素、游离甲状腺激素、促肾上腺皮质激素和胰岛素样生长因子-1 的血浆水平。
二甲双胍降低了两组患者的血浆葡萄糖、HOMA-IR 和糖化血红蛋白,但第 1 组的效果更为明显。仅在第 1 组中,治疗引起的总催乳素和单体催乳素水平的变化具有统计学意义。促甲状腺激素、游离甲状腺素、游离三碘甲状腺原氨酸、促肾上腺皮质激素和胰岛素样生长因子-1 的随访与基线值之间无差异。催乳素浓度的治疗诱导变化与基线催乳素水平、基线 HOMA-IR 值以及治疗对 HOMA-IR 的影响相关。
研究结果表明,肌醇补充可增强二甲双胍对高催乳素血症妇女催乳素水平的抑制作用。