Krysiak Robert, Basiak Marcin, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Pharmaceuticals (Basel). 2024 Jul 23;17(8):976. doi: 10.3390/ph17080976.
Metformin inhibits the secretory function of overactive anterior pituitary cells, including lactotropes. In women of childbearing age, this effect was absent if they had coexisting autoimmune (Hashimoto) thyroiditis. The current study was aimed at investigating whether autoimmune thyroiditis modulates the impact of metformin on the plasma prolactin concentration in men. This prospective cohort study included two groups of middle-aged or elderly men with drug-induced hyperprolactinemia, namely subjects with concomitant Hashimoto thyroiditis (group A) and subjects with normal thyroid function (group B), who were matched for baseline prolactin concentration and insulin sensitivity. Titers of thyroid peroxidase and thyroglobulin antibodies, levels of C-reactive protein, markers of glucose homeostasis, concentrations of pituitary hormones (prolactin, thyrotropin, gonadotropins, and adrenocorticotropic hormone), free thyroxine, free triiodothyronine, testosterone, and insulin growth factor-1 were measured before and six months after treatment with metformin. Both study groups differed in titers of both antibodies and concentrations of C-reactive protein. The drug reduced the total and monomeric prolactin concentration only in group B, and the impact on prolactin correlated with the improvement in insulin sensitivity and systemic inflammation. There were no differences between the follow-up and baseline levels of the remaining hormones. The results allow us to conclude that autoimmune thyroiditis mitigates the impact of metformin on prolactin secretion in men.
二甲双胍可抑制包括催乳素细胞在内的垂体前叶功能亢进细胞的分泌功能。在育龄女性中，如果同时患有自身免疫性（桥本氏）甲状腺炎，则不存在这种作用。本研究旨在调查自身免疫性甲状腺炎是否会调节二甲双胍对男性血浆催乳素浓度的影响。这项前瞻性队列研究纳入了两组患有药物性高催乳素血症的中年或老年男性，即合并桥本氏甲状腺炎的受试者（A组）和甲状腺功能正常的受试者（B组），两组在基线催乳素浓度和胰岛素敏感性方面相匹配。在使用二甲双胍治疗前及治疗六个月后，测量甲状腺过氧化物酶和甲状腺球蛋白抗体滴度、C反应蛋白水平、葡萄糖稳态标志物、垂体激素（催乳素、促甲状腺激素、促性腺激素和促肾上腺皮质激素）浓度、游离甲状腺素、游离三碘甲状腺原氨酸、睾酮和胰岛素生长因子-1。两个研究组在抗体滴度和C反应蛋白浓度方面均存在差异。该药物仅在B组降低了总催乳素和单体催乳素浓度，且对催乳素的影响与胰岛素敏感性和全身炎症的改善相关。其余激素的随访水平与基线水平之间无差异。结果使我们得出结论，自身免疫性甲状腺炎减轻了二甲双胍对男性催乳素分泌的影响。
