Krysiak Robert, Basiak Marcin, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, 40-752 Katowice, Poland.
Metabolites. 2025 Jan 1;15(1):9. doi: 10.3390/metabo15010009.
Untreated hyperprolactinemia and autoimmune thyroiditis (Hashimoto's disease) seem to increase cardiometabolic risk. The cardiometabolic effects of cabergoline were less significant in young women with concurrent euthyroid Hashimoto's illness. This study sought to investigate if the detrimental effects of this condition on cabergoline efficacy are also evident in postmenopausal women. The study comprised 50 postmenopausal women exhibiting increased prolactin levels, with half qualifying for euthyroid Hashimoto's illness. The subjects with thyroid autoimmunity were matched with those without thyroid disease according to age, body mass index, and prolactin levels. In addition to prolactin, we assessed thyroid-stimulating hormone (TSH), thyroid antibodies, and glucose homeostasis markers: fasting glucose, the homeostatic model assessment 1 of insulin resistance ratio (HOMA1-IR), and glycated hemoglobin (HbA1c). Furthermore, we assessed plasma lipids, plasma uric acid levels, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and the urine albumin-to-creatinine ratio (UACR). The decadal cardiovascular risk was assessed with the Framingham Risk Score (FRS). Before therapy, disparities existed among groups in HOMA1-IR, HDL cholesterol, antibody titers, uric acid, hsCRP, fibrinogen, homocysteine, UACR, and FRS. After six months of treatment, cabergoline successfully corrected prolactin levels (both total and monomeric) in women without thyroid disorders. This normalization correlated with decreases in HOMA1-IR, triglycerides, uric acid, hsCRP, fibrinogen, homocysteine, UACR, and FRS, as well as an elevation in HDL cholesterol. In women diagnosed with Hashimoto's disease, cabergoline's effects were limited to a reduction in prolactin levels, HOMA1-IR, and UACR, as well as an elevation in HDL cholesterol, with these alterations being less pronounced compared to women without thyroid illness. The cardiometabolic benefits of cabergoline were associated with the degree of prolactin concentration reduction. In women diagnosed with Hashimoto's disease, connections were noted between baseline levels and treatment-induced alterations in hsCRP. These data indicate that concurrent euthyroid autoimmune thyroiditis mitigates the cardiometabolic consequences of cabergoline.
未经治疗的高催乳素血症和自身免疫性甲状腺炎（桥本氏病）似乎会增加心脏代谢风险。对于同时患有甲状腺功能正常的桥本氏病的年轻女性，卡麦角林的心脏代谢效应不太显著。本研究旨在调查这种情况对卡麦角林疗效的不利影响在绝经后女性中是否也很明显。该研究纳入了50名催乳素水平升高的绝经后女性，其中一半符合甲状腺功能正常的桥本氏病诊断标准。患有甲状腺自身免疫性疾病的受试者与无甲状腺疾病的受试者根据年龄、体重指数和催乳素水平进行匹配。除了催乳素，我们还评估了促甲状腺激素（TSH）、甲状腺抗体和葡萄糖稳态标志物：空腹血糖、胰岛素抵抗比稳态模型评估1（HOMA1-IR）和糖化血红蛋白（HbA1c）。此外，我们还评估了血浆脂质、血浆尿酸水平、高敏C反应蛋白（hsCRP）、纤维蛋白原、同型半胱氨酸和尿白蛋白与肌酐比值（UACR）。采用弗明汉风险评分（FRS）评估十年心血管风险。治疗前，各组在HOMA1-IR、高密度脂蛋白胆固醇、抗体滴度、尿酸、hsCRP、纤维蛋白原、同型半胱氨酸、UACR和FRS方面存在差异。治疗六个月后，卡麦角林成功纠正了无甲状腺疾病女性的催乳素水平（总催乳素和单体催乳素）。这种正常化与HOMA1-IR、甘油三酯、尿酸、hsCRP、纤维蛋白原、同型半胱氨酸、UACR和FRS的降低以及高密度脂蛋白胆固醇的升高相关。在被诊断为桥本氏病的女性中，卡麦角林的作用仅限于降低催乳素水平、HOMA1-IR和UACR，以及升高高密度脂蛋白胆固醇，与无甲状腺疾病的女性相比，这些改变不太明显。卡麦角林的心脏代谢益处与催乳素浓度降低的程度相关。在被诊断为桥本氏病的女性中，观察到hsCRP的基线水平与治疗引起的变化之间存在关联。这些数据表明，同时存在的甲状腺功能正常的自身免疫性甲状腺炎减轻了卡麦角林的心脏代谢后果。
