Yanachkova Vesselina, Stankova Teodora
Department of Endocrinology, Specialized Hospital for Active Treatment of Obstetrics and Gynecology "Dr. Shterev", 1330 Sofia, Bulgaria.
Research Institute, Medical University-Pleven, 5800 Pleven, Bulgaria.
Int J Mol Sci. 2025 Apr 29;26(9):4239. doi: 10.3390/ijms26094239.
Polycystic ovarian syndrome (PCOS) is a prevalent endocrine condition in women of reproductive age, characterized also by insulin resistance, affecting both obese and non-obese individuals. Hyperprolactinemia in patients with PCOS may additionally aggravate the decline in insulin sensitivity, attributable to prolactin lipogenic effects and influence on metabolic profile. Therefore, this study aimed to investigate the serum levels of prolactin in women with PCOS and their associations with obesity, insulin resistance and prediabetes. A retrospective monocentric study was performed using the electronic database of 157 women diagnosed with PCOS. Serum prolactin, BMI, complete glucose-insulin profile and insulin resistance indices following OGTT were determined. The women with hyperprolactinemia (40.8%) had significantly higher BMI ( = 0.007), fasting glucose ( = 0.003), insulin levels ( < 0.001) and HOMA-IR ( < 0.001). The women with PCOS categorized as overweight/obese (47.1%), insulin resistant (68.8%), having impaired fasting glycaemia (28.7%) and prediabetes (36.3%) showed significantly higher levels of prolactin compared to the respective counterparts. Consequently, higher prolactin levels were significantly associated with an elevated risk of development of overweight/obesity (OR 2.59; 95% CI: 1.34-4.97, = 0.004), insulin resistance (OR 3.33; 95% CI: 1.54-7.19, = 0.002) and prediabetes (OR 1.98; 95% CI: 1.02-3.85, = 0.043) in women with PCOS. Our results suggest that hyperprolactinemia might be a pathophysiological link between obesity, insulin resistance, and carbohydrate metabolism impairments in patients with PCOS. Increased prolactin levels may serve as an additional indicator of insulin resistance and even further exacerbate it in women with PCOS.
多囊卵巢综合征（PCOS）是育龄女性中一种常见的内分泌疾病，其特征还包括胰岛素抵抗，影响肥胖和非肥胖个体。PCOS患者的高催乳素血症可能会进一步加重胰岛素敏感性的下降，这归因于催乳素的脂肪生成作用及其对代谢状况的影响。因此，本研究旨在调查PCOS女性的血清催乳素水平及其与肥胖、胰岛素抵抗和糖尿病前期的关系。我们使用157例诊断为PCOS的女性的电子数据库进行了一项回顾性单中心研究。测定了血清催乳素、BMI、完整的葡萄糖-胰岛素谱以及口服葡萄糖耐量试验（OGTT）后的胰岛素抵抗指数。高催乳素血症女性（40.8%）的BMI（P = 0.007）、空腹血糖（P = 0.003）、胰岛素水平（P < 0.001）和稳态模型评估胰岛素抵抗（HOMA-IR）（P < 0.001）显著更高。与各自的对照组相比，被归类为超重/肥胖（47.1%）、胰岛素抵抗（68.8%）、空腹血糖受损（28.7%）和糖尿病前期（36.3%）的PCOS女性的催乳素水平显著更高。因此，较高的催乳素水平与PCOS女性发生超重/肥胖（比值比[OR] 2.59；95%置信区间[CI]：1.34 - 4.97，P = 0.004）、胰岛素抵抗（OR 3.33；95% CI：1.54 - 7.19，P = 0.002）和糖尿病前期（OR 1.98；95% CI：1.02 - 3.85，P = 0.043）的风险显著相关。我们的结果表明，高催乳素血症可能是PCOS患者肥胖、胰岛素抵抗和碳水化合物代谢受损之间的病理生理联系。催乳素水平升高可能是胰岛素抵抗的一个额外指标，并且在PCOS女性中甚至可能进一步加剧胰岛素抵抗。
