Shen Yun, Yang Qing, Hu Tingting, Wang Yaxin, Chen Lei, Gao Fei, Zhu Wei, Hu Gang, Zhou Jian, Wang Chunfang, Bao Yuqian
Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, 600 Yishan Road, Shanghai 200233, China.
Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 200336, China.
Eur J Prev Cardiol. 2023 Oct 10;30(14):1439-1447. doi: 10.1093/eurjpc/zwad112.
The association between prolactin and mortality has been less studied, and findings were inconsistent among different populations. We aimed to investigate the association between serum prolactin (PRL) and mortality among patients with type 2 diabetes.
We performed a retrospective cohort study of 10 907 patients with at least 2 prolactin measurements within 2 years since their first inpatient diagnosis of type 2 diabetes. Baseline and mean values of serum PRL were used as exposures. A multivariable-adjusted Cox proportional hazards model was used to estimate the association between PRL and mortality. During a mean follow-up of 5.34 years, 863 patients died, of whom 274 were due to cardiovascular events. Multivariable-adjusted hazard ratios (aHRs) based on different levels of baseline PRL (<100, 100-199, 200-299, and ≥300 mIU/L) were 1.00, 1.10 [95% confidence interval (CI), 0.90-1.36], 1.35 (95% CI 1.11-1.67), and 1.49 (95% CI 1.18-1.84) for all-cause mortality and 1.00, 1.24 (95% CI 0.86-1.81), 1.71 (95% CI 1.14-2.62), and 2.42 (95% CI 1.55-3.78) for cardiovascular mortality, respectively. Positive associations were also found when we used the mean values of PRL as the exposure. These associations were consistent among patients of different baseline characteristics. Further sensitivity analyses excluding patients with subclinical or clinical hypothyroidism at baseline and who died within the first 6 months since baseline demonstrated similar results.
A positive association between baseline PRL and mortality was observed among patients with type 2 diabetes. Prolactin may be considered a potential biomarker of mortality among patients with type 2 diabetes.
催乳素与死亡率之间的关联研究较少，且不同人群的研究结果不一致。我们旨在调查2型糖尿病患者血清催乳素（PRL）与死亡率之间的关联。
我们对10907例2型糖尿病患者进行了一项回顾性队列研究，这些患者在首次住院诊断为2型糖尿病后的2年内至少进行了2次催乳素测量。血清PRL的基线值和平均值用作暴露因素。采用多变量调整的Cox比例风险模型来估计PRL与死亡率之间的关联。在平均5.34年的随访期间，863例患者死亡，其中274例死于心血管事件。基于不同基线PRL水平（<100、100 - 199、200 - 299和≥300 mIU/L）的多变量调整风险比（aHRs），全因死亡率分别为1.00、1.10 [95%置信区间（CI），0.90 - 1.36]、1.35（95% CI 1.11 - 1.67）和1.49（95% CI 1.18 - 1.84），心血管死亡率分别为1.00、1.24（95% CI 0.86 - 1.81）、1.71（95% CI 1.14 - 2.62）和2.42（95% CI 1.55 - 3.78）。当我们将PRL的平均值用作暴露因素时，也发现了正相关。这些关联在不同基线特征的患者中是一致的。进一步的敏感性分析排除了基线时患有亚临床或临床甲状腺功能减退症以及在基线后前6个月内死亡的患者，结果相似。
在2型糖尿病患者中观察到基线PRL与死亡率之间存在正相关。催乳素可被视为2型糖尿病患者死亡率的潜在生物标志物。
