Detomas Mario, Deutschbein Timo, Dolce Pasquale, Möhres Yvonne, Fassnacht Martin, Altieri Barbara
Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany.
Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK.
Pituitary. 2025 Feb 3;28(1):24. doi: 10.1007/s11102-024-01493-x.
Despite prolactin´s (PRL) role in stimulating hematopoiesis, anemia is commonly observed in men with macroprolactinomas. However, hematological changes in men with microprolactinomas and women with prolactinomas remain unexplored, and the impact of erythropoietic alterations on quality of life (QoL) is still unclear.
To explore sex-related changes in red blood cell (RBC) parameters and their potential impact on QoL at initial diagnosis of prolactinoma and after normalization of PRL under dopamine agonists.
Retrospective, monocentric study involving 205 patients with prolactinoma (127 women, 62%). The SF-36 QoL questionnaire was administered to 57 women and 34 men.
In women, no significant changes in RBC parameters were observed at diagnosis or after PRL normalization, regardless the adenoma size. Conversely, men with microprolactinoma showed a significant increase in hematocrit (HCT) and hemoglobin (Hb) levels after PRL normalization (median HCT 42.3 vs.44.0%; Hb 14.5 vs. 15.1 g/dL; both p < 0.005). Men with macroprolactinoma exhibited similar improvements (HCT 40.2 vs. 43.9%; Hb 14.0 vs. 15.1 g/dL; both p < 0.0001). In men, hypogonadism was observed in 73% of patients at baseline, and in 11% after PRL normalization. In male patients where SF-36 was administered at diagnosis and after PRL normalization, energy improvement was observed (median 50 vs. 60, p < 0.05). While changes in Hb and HCT were not significantly impacting the QoL of women and men, persistence of hypogonadism after PRL normalization, negatively impacted all the QoL scores of men.
Patients with prolactinoma show sex-dependent changes in RBC parameters. Unlike women, men exhibit decreased HCT and Hb levels irrespective of adenoma size. Of note, the failure to recover from hypogonadism significantly affected the QoL of men.
尽管催乳素（PRL）在刺激造血过程中发挥作用，但大泌乳素瘤男性患者中贫血却很常见。然而，微泌乳素瘤男性患者和泌乳素瘤女性患者的血液学变化仍未得到研究，并且红细胞生成改变对生活质量（QoL）的影响仍不清楚。
探讨泌乳素瘤初诊时以及多巴胺激动剂使PRL正常化后，红细胞（RBC）参数的性别相关变化及其对生活质量的潜在影响。
一项回顾性、单中心研究，纳入205例泌乳素瘤患者（127例女性，占62%）。对57例女性和34例男性进行了SF-36生活质量问卷调查。
在女性中，无论腺瘤大小，诊断时或PRL正常化后RBC参数均未观察到显著变化。相反，微泌乳素瘤男性患者PRL正常化后，血细胞比容（HCT）和血红蛋白（Hb）水平显著升高（HCT中位数42.3%对44.0%；Hb 14.5对15.1 g/dL；两者p均<0.005）。大泌乳素瘤男性患者也有类似改善（HCT 40.2%对43.9%；Hb 14.0对15.1 g/dL；两者p均<0.0001）。在男性中，73%的患者基线时存在性腺功能减退，PRL正常化后这一比例为11%。在诊断时和PRL正常化后接受SF-36调查的男性患者中，观察到精力有所改善（中位数50对60，p<0.05）。虽然Hb和HCT的变化对女性和男性的生活质量没有显著影响，但PRL正常化后性腺功能减退的持续存在对男性所有生活质量评分产生了负面影响。
泌乳素瘤患者的RBC参数存在性别依赖性变化。与女性不同，男性无论腺瘤大小，HCT和Hb水平均降低。值得注意的是，性腺功能减退未能恢复显著影响了男性的生活质量。
