Prolactina e metabolismo – uma perspetiva diferente de uma hormona multifuncional

Abstract

IntroductionProlactin presents unique molecular and physiological characteristics that allow it to perform numerous functions. In addition to its role in lactation and in the regulation of reproductive function, this hormone affects multiple aspects of human homeostasis. Recently has been attracting attention for its properties in energetic metabolism. ObjectivesTo describe prolactin effects in glucose metabolism and adipose tissue function. MethodsSystematic search in PubMed database of the original articles or systematic reviews published until May 2013. The search terms used were:: «prolactin», «metabolism», «adipose tissue», «obesity», «diabetes mellitus» and «dopaminergic tone», ConclusionsProlactin affects several key aspects of energy homeostasis. This hormone influences β cell mass, insulin sensitivity and adipocytes structure and function through autocrine, paracrine and endocrine mechanisms. Under pathological conditions, especially in the presence of prolactinomas, hyperprolactinemia seems to contribute to the development of pathologies as diabetes mellitus and obesity. The reduction of the dopaminergic tone, resulting from maintained hyperprolactinemia, represents the most consensual hypothesis to integrate many of the metabolic abnormalities observed in patients with prolactinomas. In these patients, treatment with dopaminergic agonists conditions significant metabolic parameters improvement, namely a reduction in insulin resistance, improvement in glycemic control and weight loss. Thus, this review highlights the importance of an accurate evaluation of the metabolic profile of patients with prolactinomas allowing it to be considered in therapeutic decisions.