Baba Mohammad Salem, Islam Mir Sajad Ul, Bhat Moomin Hussain, Laway Bashir Ahmad, Misgar Raiz Ahmad
Endocrinology, Government Superspeciality Hospital, Srinagar, IND.
Endocrinology, Hamdard Institute of Medical Sciences and Research, New Delhi, IND.
Cureus. 2023 Aug 3;15(8):e42911. doi: 10.7759/cureus.42911. eCollection 2023 Aug.
Background and objective Individuals with prolactinoma exhibit elevated rates of obesity, metabolic syndrome (MS), and dyslipidemia compared to their healthy counterparts. However, there is a lack of data regarding metabolic variance between male and female prolactinoma patients. Consequently, this study aimed to investigate and compare sex-specific discrepancies in metabolic abnormalities among individuals diagnosed with prolactinoma. Methods In this prospective study, 80 treatment-naïve patients with prolactinoma (12 males and 68 females) underwent clinical assessments and laboratory investigations. The measured parameters included blood glucose, total cholesterol (TC), triglycerides (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), urea, creatinine, uric acid, and blood glucose levels. The patients were treated with cabergoline, a dopamine agonist, and reevaluated after 12 weeks. Results Forty-eight patients had microprolactinomas (all females), and 32 had macroprolactinomas (20 females, 12 males). The mean age was 28.30±7.49 years for females and 28.91±7.12 years for males (p=0.71). The median symptom duration was 12 months (range 1-72 months, IQR 4-16 months), with no significant difference between males (median 12 months, IQR 5-54 months) and females (median 12 months, IQR 10-24 months, p=0.620). The median serum prolactin (PRL) was 988 ng/mL (IQR 471-1,439) in males and 165 ng/mL (IQR 90-425) in females (p<0.05). Males showed higher HbA1c, BGF, TC, TG, LDL-C, and higher rates of obesity, MS, and diabetes mellitus. Treatment with cabergoline resulted in significant improvements in the HbA1c, BGF, TC, TG, and LDL-C levels. Conclusion Males with prolactinomas had larger tumor sizes and higher serum PRL levels than females. Additionally, males exhibited worse metabolic parameters than females. However, there was no significant difference in the duration of symptoms or age at diagnosis between the two groups.
与健康人群相比，泌乳素瘤患者肥胖、代谢综合征（MS）和血脂异常的发生率更高。然而，关于男性和女性泌乳素瘤患者代谢差异的数据尚缺乏。因此，本研究旨在调查和比较泌乳素瘤患者中代谢异常的性别特异性差异。方法：在这项前瞻性研究中，80例未经治疗的泌乳素瘤患者（12例男性和68例女性）接受了临床评估和实验室检查。测量参数包括血糖、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、尿素、肌酐、尿酸和血糖水平。患者接受多巴胺激动剂卡麦角林治疗，并在12周后重新评估。结果：48例患者为微泌乳素瘤（均为女性），32例为大泌乳素瘤（20例女性，12例男性）。女性的平均年龄为28.30±7.49岁，男性为28.91±7.12岁（p = 0.71）。症状持续时间的中位数为12个月（范围1 - 72个月，四分位间距4 - 16个月），男性（中位数12个月，四分位间距5 - 54个月）和女性（中位数12个月，四分位间距10 - 24个月）之间无显著差异（p = 0.620）。男性血清泌乳素（PRL）中位数为988 ng/mL（四分位间距471 - 1439），女性为165 ng/mL（四分位间距90 - 425）（p < 0.05）。男性的糖化血红蛋白、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平更高，肥胖、代谢综合征和糖尿病的发生率也更高。卡麦角林治疗使糖化血红蛋白、空腹血糖、总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平有显著改善。结论：泌乳素瘤男性患者的肿瘤体积比女性大，血清泌乳素水平也更高。此外，男性的代谢参数比女性更差。然而，两组患者的症状持续时间或诊断时年龄无显著差异。
