Kovacs C S, Chik C L
Department of Medicine, University of Alberta, Edmonton, Canada.
J Clin Endocrinol Metab. 1995 Oct;80(10):3036-42. doi: 10.1210/jcem.80.10.7559893.
PRL stimulates systemic release of PTH-related peptide (PTHrP) in animals. To determine whether hyperprolactinemia causes PTHrP release in humans, we studied the relationship between PRL and PTHrP in lactating women and patients with PRL-producing pituitary adenomas. Thirty-three lactating women and 16 patients with pituitary adenomas were paired with healthy age- and sex-matched controls. Serum total calcium, albumin, phosphate, PRL, intact PTH, and PTHrP were measured. Mean calcium and phosphate levels were higher in lactating women than in control subjects [2.39 +/- 0.01 vs. 2.35 +/- 0.01 mmol/L (P < 0.01) and 1.33 +/- 0.03 vs. 1.13 +/- 0.02 mmol/L (P << 0.001), respectively]. Mean PTH was lower (2.49 +/- 0.24 vs. 3.17 +/- 0.23 pmol/L; P < 0.04) and mean PTHrP was higher than control values (0.93 + 0.08 vs. 0.38 +/- 0.04 pmol/L; P << 0.001). PRL correlated negatively with PTH (P < 0.02) and positively with PTHrP (P < 0.05). Mean calcium, phosphate, and PTH levels were not different between patients with pituitary adenomas and control subjects. The mean PTHrP level was higher in patients with pituitary adenomas (0.75 +/- 0.10 vs. 0.39 +/- 0.07 pmol/L; P < 0.006) and fell significantly with therapy to normalize PRL (P < 0.03). We conclude that PTHrP levels are increased in hyperprolactinemia caused by lactation and pituitary adenomas. In lactating women, the increased PTHrP was associated with higher mean calcium and phosphate and lower PTH levels. The metabolic consequences of these abnormalities in hyperprolactinemia require further elucidation.
催乳素（PRL）可刺激动物体内甲状旁腺激素相关肽（PTHrP）的全身释放。为了确定高催乳素血症是否会导致人体释放PTHrP，我们研究了哺乳期妇女以及患有分泌PRL的垂体腺瘤患者体内PRL与PTHrP之间的关系。33名哺乳期妇女和16名垂体腺瘤患者与年龄和性别相匹配的健康对照者进行配对。检测血清总钙、白蛋白、磷酸盐、PRL、完整甲状旁腺激素（PTH）和PTHrP。哺乳期妇女的平均钙和磷酸盐水平高于对照者[分别为2.39±0.01 vs. 2.35±0.01 mmol/L（P<0.01）和1.33±0.03 vs. 1.13±0.02 mmol/L（P<<0.001）]。平均PTH较低（2.49±0.24 vs. 3.17±0.23 pmol/L；P<0.04），平均PTHrP高于对照值（0.93 + 0.08 vs. 0.38±0.04 pmol/L；P<<0.001）。PRL与PTH呈负相关（P<0.02），与PTHrP呈正相关（P<0.05）。垂体腺瘤患者与对照者之间的平均钙、磷酸盐和PTH水平无差异。垂体腺瘤患者的平均PTHrP水平较高（0.75±0.10 vs. 0.39±0.07 pmol/L；P<0.006），且随着使PRL正常化的治疗而显著下降（P<0.03）。我们得出结论，哺乳期和垂体腺瘤引起的高催乳素血症中PTHrP水平升高。在哺乳期妇女中，升高的PTHrP与较高的平均钙和磷酸盐水平以及较低的PTH水平相关。高催乳素血症中这些异常的代谢后果需要进一步阐明。
