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.
J Clin Pharmacol. 2023 Aug;63(8):886-894. doi: 10.1002/jcph.2245. Epub 2023 May 8.
Both prolactin excess and autoimmune (Hashimoto) thyroiditis may predispose to the development of cardiometabolic disorders. The aim of this study was to investigate whether autoimmune thyroiditis determines cardiometabolic effects of cabergoline. The study population consisted of 2 groups of young women: 32 women with euthyroid Hashimoto thyroiditis (group A) and 32 individuals without thyroid disorders (group B). Both groups were matched for age, body mass index, blood pressure, and prolactin levels. Plasma prolactin, thyroid antibodies, glucose homeostasis markers, plasma lipids, circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, and the urinary albumin-to-creatinine ratio were assessed before and after 6 months of cabergoline treatment. All women completed the study. Both groups differed in thyroid antibody titers, insulin sensitivity, high-density lipoprotein cholesterol, hsCRP, homocysteine, and the albumin-to-creatinine ratio. Although cabergoline treatment reduced prolactin levels, improved insulin sensitivity, decreased glycated hemoglobin, increased high-density lipoprotein cholesterol, decreased hsCRP, and reduced the albumin-to-creatinine ratio in both treatment groups, these effects (except for glycated hemoglobin) were more pronounced in group B than in group A. Only in group B, the drug decreased triglycerides, uric acid, fibrinogen, and homocysteine. In group A, hsCRP levels correlated with both baseline thyroid antibody titers and with other cardiometabolic risk factors. The impact of cabergoline on cardiometabolic risk factors depended on the degree of reduction in prolactin levels, while in group A additionally correlated with the effect of treatment on hsCRP. The obtained results suggest that coexisting autoimmune thyroiditis attenuates cardiometabolic effects of cabergoline in young women with hyperprolactinemia.
催乳素过多和自身免疫性（桥本）甲状腺炎都可能导致代谢紊乱。本研究旨在探讨自身免疫性甲状腺炎是否决定卡麦角林的代谢作用。研究人群包括两组年轻女性：32 名甲状腺功能正常的桥本甲状腺炎患者（A 组）和 32 名无甲状腺疾病患者（B 组）。两组在年龄、体重指数、血压和催乳素水平方面相匹配。在卡麦角林治疗 6 个月前后，评估了两组患者的血浆催乳素、甲状腺抗体、葡萄糖稳态标志物、血脂、尿酸、高敏 C 反应蛋白（hsCRP）、纤维蛋白原和同型半胱氨酸的循环水平以及尿白蛋白与肌酐的比值。所有女性均完成了研究。两组之间在甲状腺抗体滴度、胰岛素敏感性、高密度脂蛋白胆固醇、hsCRP、同型半胱氨酸和白蛋白与肌酐比值方面存在差异。尽管卡麦角林治疗降低了催乳素水平，改善了胰岛素敏感性，降低了糖化血红蛋白，增加了高密度脂蛋白胆固醇，降低了 hsCRP，并降低了两组的白蛋白与肌酐比值，但这些影响（除了糖化血红蛋白）在 B 组比 A 组更为明显。仅在 B 组中，该药物降低了甘油三酯、尿酸、纤维蛋白原和同型半胱氨酸。在 A 组中，hsCRP 水平与基线甲状腺抗体滴度以及其他心血管代谢危险因素相关。卡麦角林对心血管代谢危险因素的影响取决于催乳素水平降低的程度，而在 A 组中，还与 hsCRP 的治疗效果相关。研究结果表明，在患有高催乳素血症的年轻女性中，同时存在自身免疫性甲状腺炎会减弱卡麦角林的代谢作用。
