Macroprolactinemia, like hyperprolactinemia, may promote platelet activation

Abstract

Insulin resistance, which provides a convenient milieu for platelet activation, has been closely associated with atherosclerotic disorders. Although it often accompanies hyperprolactinemia, findings conflict concerning its clinical impact in macroprolactinemia. In order to investigate the relationship between hyperprolactinemia and platelet activation evidenced by ADP-stimulated P-selectin expression on flow cytometry, we studied hyperprolactinemic, macroprolactinemic, and normoprolactinemic subjects. Thirty-four hyperprolactinemic and 44 age- and body mass index-matched euprolactinemic premenopausal women were included. They were matched regarding insulin sensitivity status, waist circumference, blood pressures, and plasma lipids. In order to detect macroprolactinemia among hyperprolactinemic cases, prolactin was measured before and after polyethylene glycol (PEG) precipitation in patients' sera. P-selectin expression was significantly higher in the hyperprolactinemic group (P =0.001), and 41.2% of them exhibited macroprolactinemia. Expression of P-selectin was comparable between the macroprolactin-negative (monomeric hyperprolactinemia; n = 20) and -positive (n = 14) subgroups (P = 0.90). Both subgroups showed greater expression compared with normoprolactinemic controls (P = 0.014 and 0.005, respectively). Platelet activation accompanies the atherosclerotic disorders closely associated with insulin resistance. Among groups matched with regard to insulin-sensitivity markers, both monomeric hyperprolactinemia and macroprolactinemia appeared to promote platelet activation.

Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers

“…However, almost all of these studies included fewer than 30 patients with hyperprolactinemia. Therefore, the strength of the current study is its large sample size of approximately 100 men and women with hyperprolactinemia, which is nearly three times that of any previous study 27,28…”

“…Erem et al27 reported that the levels of fibrinogen and antithrombin III among patients with prolactinoma were significantly increased compared with control participants. Similarly, Anaforoglu et al28 found that adenosine diphosphate (ADP)-stimulated expression was significantly greater in the hyperprolactinemia group than in the control group; this ADP-stimulated expression provides evidence of platelet activation. Based on these findings, prolactin is regarded as a hormone-associated coagulant, and patients with hyperprolactinemia are considered at risk for VTE.…”

14. Approach to the Patient with Persistent Hyperprolactinemia and Negative Sellar Imaging

“…Anaforoglu et al (47) studied platelet activation looking at P-selectin expression in hyperprolactinemic, macroprolactinemic, and normoprolactinemic subjects, matched regarding blood pressure, plasma lipids, waist circumference, and insulin sensitivity status. Platelet activation was greater in hyperprolactinemic and macroprolactinemic patients.…”

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“…The possible negative effect of macroprolactin is still controversial. Anaforoglu et al showed that a group of patients with monomeric hyperprolactinemia and macroprolactinemia compared to a group with normoprolactinemia demonstrated greater platelet activation and atherosclerotic disorders [92]. Further research is necessary to elucidate the potential biological effect of macroprolactin and its treatment requirement.…”