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, 41-902 Bytom, Poland.
Biomolecules. 2024 Oct 20;14(10):1335. doi: 10.3390/biom14101335.
Low prolactin levels in men predispose them to mood disturbances, sexual dysfunction, and diabetes. The purpose of the current study was to assess cardiometabolic risk in males with hypoprolactinemia. This prospective study included three age-matched groups of young and middle-aged men: individuals with cabergoline-induced hypoprolactinemia ( = 15), cabergoline-treated subjects with prolactin levels within the reference range ( = 20), and untreated men with normal prolactin levels ( = 31). In men with hypoprolactinemia, the cabergoline dose was reduced in order to normalize prolactin concentration. Anthropometric parameters, blood pressure, QRISK3 score; plasma concentrations of prolactin, glucose, insulin, lipids, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and testosterone; whole-blood levels of glycated hemoglobin (HbA); urinary albumin-to-creatinine ratio (UACR); and carotid intima-media thickness were assessed at baseline and six months later. Men with hypoprolactinemia were characterized by higher body mass index, fat content, waist circumference, systolic blood pressure, fasting and 2 h post-load glucose, HbA, HOMA1-IR, uric acid, hsCRP, fibrinogen, homocysteine, and UACR; by lower HDL cholesterol and testosterone; by greater intima-media thickness; and by a higher QRISK3 score than their peers with normal prolactin levels. There were no statistically significant differences in the measured parameters between both groups of men with normal prolactin levels. Normalization of prolactin concentration was accompanied by normalization of biochemical variables, systolic blood pressure, and QRISK3 score. Although cabergoline dose reduction did not cause statistically significant changes in the remaining anthropometric parameters and intima-media thickness, six months later, they did not differ from those observed in the remaining study groups. Our findings suggest that iatrogenic hypoprolactinemia is associated with increased cardiometabolic risk, which is reversible and resolves after the normalization of prolactin levels.
男性的催乳素水平低会导致情绪紊乱、性功能障碍和糖尿病。本研究的目的是评估催乳素低下男性的心脏代谢风险。这项前瞻性研究包括三组年龄匹配的年轻和中年男性：卡麦角林诱导的催乳素低下个体（n = 15）、催乳素水平在参考范围内的卡麦角林治疗组（n = 20）和催乳素水平正常的未治疗组（n = 31）。为了使催乳素浓度正常化，减少了催乳素低下男性的卡麦角林剂量。在基线和六个月后评估了人体测量参数、血压、QRISK3 评分；催乳素、葡萄糖、胰岛素、脂质、尿酸、高敏 C 反应蛋白（hsCRP）、纤维蛋白原、同型半胱氨酸和睾酮的血浆浓度；全血糖化血红蛋白（HbA）水平；尿白蛋白与肌酐比值（UACR）；颈动脉内膜中层厚度。催乳素低下的男性表现为体重指数、脂肪含量、腰围、收缩压、空腹和负荷后 2 小时血糖、HbA、HOMA1-IR、尿酸、hsCRP、纤维蛋白原、同型半胱氨酸和 UACR 较高；高密度脂蛋白胆固醇和睾酮较低；内膜中层厚度较大；QRISK3 评分较高，与催乳素水平正常的同龄人相比。两组催乳素水平正常的男性在测量参数上无统计学差异。催乳素浓度正常化伴随着生化变量、收缩压和 QRISK3 评分的正常化。虽然卡麦角林剂量减少并未导致其余人体测量参数和内膜中层厚度的统计学显著变化，但六个月后，它们与其余研究组观察到的结果无差异。我们的研究结果表明，医源性催乳素低下与心脏代谢风险增加有关，这种风险是可逆的，在催乳素水平正常化后会得到缓解。
