Abstract
BackgroundHyperprolactinaemia might cause adverse metabolic effects. The aim of our study was to compare parameters of body composition, glucose and lipid metabolism between untreated patients with prolactinoma and controls and to assess changes after initiation of cabergoline.MethodsCase-control study with a retrospectively analyzed follow-up in patients with prolactinoma after initiation of cabergoline therapy.Results21 patients with prolactinoma (9 micro- and 12 macroprolactinomas; 7 females) and 30 controls were analyzed. Patients with prolactinoma had significantly higher BMI than controls; fat mass did not differ between groups. Only men - but not women - with prolactinoma had significantly higher fat mass at all six sites measured compared to controls. Levels of LDL (130 (107–147.5) vs. 94.5 (80–127.5) mg/dl, p < 0.001) were significantly higher, levels of HDL (56 ± 16.7 vs. 69.2 ± 14.6 mg/dl, p = 0.004) significantly lower than in controls. Fasting glucose, HOMA-IR, HbA1c, adiponectin, CRP, and homocysteine did not differ between groups.After a median of 10 weeks (IQR 7–18 weeks) after initiation of cabergoline, total (from 212.5 ± 36.2 to 196.9 ± 40.6 mg/dl, p = 0.018) and LDL cholesterol (130 (107–147.5) to 106.5 (94.3–148) mg/dl, p = 0.018) had significantly decreased. Analyzing men and women separately, this change occurred in men only.ConclusionsReasons for the association between prolactin and metabolic parameters include direct effects of prolactin on adipose tissue, hyperprolactinaemia-triggered hypogonadism and dopamine-agonist therapy per se. Altered lipid metabolism in patients with prolactinoma might imply an increased cardiovascular risk, highlighting the necessity to monitor metabolic parameters in these patients.
Highlights
IntroductionWeight gain, increased body fat content in untreated patients with prolactinoma as shown in some studies [1] and reduction of waist circumference after cabergoline treatment [2] might be linked to the influence of prolactin on appetite-regulating systems [3,4,5]
In addition to effects on gonadal function, hyperprolactinaemia caused by prolactin secreting tumors of the pituitary gland or the intake of antipsychotic drugs might have effects on food intake, weight gain as well as on glucose and lipid metabolism.Weight gain, increased body fat content in untreated patients with prolactinoma as shown in some studies [1] and reduction of waist circumference after cabergoline treatment [2] might be linked to the influence of prolactin on appetite-regulating systems [3,4,5]
homeostasis model assessment insulin resistance (HOMA-IR), haemoglobin A1c (HbA1c), adiponectin, C-reactive protein (CRP), homocysteine did not differ between groups
Summary
Weight gain, increased body fat content in untreated patients with prolactinoma as shown in some studies [1] and reduction of waist circumference after cabergoline treatment [2] might be linked to the influence of prolactin on appetite-regulating systems [3,4,5]. Retrospective study including 53 patients with prolactinomas, no effect on fasting glucose and HbA1c was seen after a median of nine months of cabergoline treatment [12]. The aim of our study was to compare parameters of body composition, glucose and lipid metabolism between untreated patients with prolactinoma and controls and to assess changes after initiation of cabergoline
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