Auriemma Renata S, Scairati Roberta, Pirchio Rosa, Del Vecchio Guendalina, Di Meglio Sara, Menafra Davide, Pivonello Rosario, Colao Annamaria
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Università Federico II di Napoli, Via Sergio Pansini 5, 80131, Naples, Italy.
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Unità di Andrologia e Medicina della Riproduzione, Sessualità e Affermazione di Genere, Università Federico II di Napoli, Naples, Italy.
Rev Endocr Metab Disord. 2024 Dec;25(6):1065-1075. doi: 10.1007/s11154-024-09891-z. Epub 2024 Jul 30.
The fall of PRL levels below the lower limit of the normal range configures the condition of hypoprolactinemia. Unlike PRL excess, whose clinical features and treatments are well established, hypoprolactinemia has been only recently described as a morbid entity requiring prompt identification and proper therapeutic approach. Particularly, hypoprolactinemia has been reported to be associated with the development of metabolic syndrome and impaired cardiometabolic health, as visceral obesity, insulin-resistance, diabetes mellitus, dyslipidaemia, chronic inflammation, and sexual dysfunction have been found more prevalent in patients with hypoprolactinemia as compared to those with normoprolactinemia. This evidence has been collected mainly in patients on chronic treatment with dopamine agonists for PRL excess due to a PRL-secreting pituitary tumour, and less frequently in those receiving the atypical antipsychotic aripiprazole. Nowadays, hypoprolactinemia appears to represent a novel and unexpected risk factor for cardiovascular diseases, as is the case for hyperprolactinemia. Nevertheless, current knowledge still lacks an accurate biochemical definition of hypoprolactinemia, since no clear PRL threshold has been established to rule in the diagnosis of PRL deficiency enabling early identification of those individual subjects with increased cardiovascular risk directly ascribable to the hormonal imbalance. The current review article focuses on the effects of hypoprolactinemia on the modulation of body weight, gluco-insulinemic and lipid profile, and provides latest knowledge about potential cardiovascular outcomes of hypoprolactinemia.
催乳素（PRL）水平降至正常范围下限以下即构成低催乳素血症。与催乳素过多（其临床特征和治疗方法已明确）不同，低催乳素血症直到最近才被描述为一种需要及时识别和采取适当治疗方法的疾病实体。特别是，据报道低催乳素血症与代谢综合征的发生以及心脏代谢健康受损有关，因为与催乳素水平正常的患者相比，低催乳素血症患者的内脏肥胖、胰岛素抵抗、糖尿病、血脂异常、慢性炎症和性功能障碍更为普遍。这些证据主要收集于因分泌催乳素的垂体瘤而接受多巴胺激动剂长期治疗的患者中，在接受非典型抗精神病药物阿立哌唑治疗的患者中则较少见。如今，低催乳素血症似乎代表了一种新的、意想不到的心血管疾病风险因素，高催乳素血症也是如此。然而，目前的知识仍然缺乏对低催乳素血症的准确生化定义，因为尚未确立明确的催乳素阈值来确诊催乳素缺乏，从而无法早期识别那些直接归因于激素失衡而心血管风险增加的个体。本综述文章重点关注低催乳素血症对体重调节、糖胰岛素代谢和血脂谱的影响，并提供有关低催乳素血症潜在心血管结局的最新知识。
