Krysiak Robert, Kowalcze Karolina, Madej Andrzej, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, 40-752 Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Stefana Batorego 15, 41-902 Bytom, Poland.
J Clin Med. 2023 May 31;12(11):3769. doi: 10.3390/jcm12113769.
Metformin decreases elevated prolactin levels, which are frequently found in patients with thyroid disorders. The aim of this study was to investigate whether thyroid autoimmunity modulates the impact of metformin on lactotrope secretory function. This study compared two matched groups of young women with prediabetes and mild-to-moderate prolactin excess: 28 subjects with coexisting euthyroid autoimmune thyroiditis (group 1) and 28 individuals without thyroid disorders (group 2), treated for six months with metformin (3 g daily). Thyroid antibody titers, glucose homeostasis markers, prolactin, thyrotropin, free thyroid hormones, FSH, LH, ACTH, IGF-1 and hsCRP were assessed at the beginning and at the end of the study. At entry, the study groups differed in antibody titers and hsCRP levels. Although the improvement in glucose homeostasis and the decrease in hsCRP levels were observed in both study groups, they were more pronounced in group 2. Only in group 2 did metformin reduce circulating prolactin levels (both total and monomeric). Prolactin-lowering properties of metformin positively correlated with baseline prolactin levels, baseline antibody titers (in group 1) and with the degree of reduction in hsCRP levels. The obtained results suggest that autoimmune thyroiditis may attenuate the impact of metformin on lactotrope secretory function.
二甲双胍可降低甲状腺疾病患者中常见的升高的催乳素水平。本研究的目的是调查甲状腺自身免疫是否会调节二甲双胍对催乳素细胞分泌功能的影响。本研究比较了两组匹配的患有糖尿病前期和轻度至中度催乳素过多的年轻女性：28名患有甲状腺功能正常的自身免疫性甲状腺炎的受试者（第1组）和28名无甲状腺疾病的个体（第2组），用二甲双胍（每日3克）治疗六个月。在研究开始和结束时评估甲状腺抗体滴度、葡萄糖稳态标志物、催乳素、促甲状腺激素、游离甲状腺激素、促卵泡激素、促黄体生成素、促肾上腺皮质激素、胰岛素样生长因子-1和高敏C反应蛋白。在入组时，研究组在抗体滴度和高敏C反应蛋白水平上存在差异。虽然在两个研究组中均观察到葡萄糖稳态的改善和高敏C反应蛋白水平的降低，但在第2组中更为明显。仅在第2组中，二甲双胍降低了循环催乳素水平（总催乳素和单体催乳素）。二甲双胍的催乳素降低特性与基线催乳素水平、基线抗体滴度（在第1组中）以及高敏C反应蛋白水平的降低程度呈正相关。所得结果表明，自身免疫性甲状腺炎可能会减弱二甲双胍对催乳素细胞分泌功能的影响。
