Metabolic effects of dopamine-agonists treatment among patients with prolactinomas

Abstract

Purpose: To evaluate the effect of cabergoline treatment on metabolic parameters including the Triglyceride-glucose (TyG) index in newly diagnosed patients with prolactinoma.Methods: 71 consecutive non-diabetic patients with prolactinoma were enrolled. Body mass index (BMI), blood pressure, and laboratory tests including TyG index were measured for each patient. Then, treatment with cabergoline was started for each patient and continued for 6 months. Anthropometric and laboratory tests were repeated every 3 months to evaluate the effects of cabergoline treatment.Results: At the baseline examination, the mean (SD) age, BMI, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) of patients were 36.2 (10.5) years, 29.2 (5.0) kg/m 2 , 98.2 (13.7) cm, 115.3 (13.3) mmHg, and 71.4 (8.1) mmHg, respectively. Furthermore, men were older and had higher values for BMI, WC, SBP, and metabolic syndrome (MetS) prevalence compared to women. Cabergoline treatment signi cantly improved anthropometric and metabolic measures including BMI, WC, fasting plasma glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid (only among women), TyG index, and hypogonadism, while no signi cant change was detected in SBP and DBP. No signi cant change was found in Mets syndrome prevalence among women whereas the declining trend from baseline to 3-month evaluation was signi cant among men.Conclusion: Short-term treatment with cabergoline can signi cantly improve cardiovascular risk factors except for blood pressure. Moreover, the TyG index as a surrogate marker of insulin resistance decreased signi cantly after the reduction of prolactin by treatment. Generally, results were similar among both genders.

Alternations of Blood Pressure Following Surgical or Drug Therapy for Prolactinomas

“…These data indicate that the ability of BRC to decrease BP depends on certain conditions. More recently, Kabootari et al [34] demonstrated that another, more mainstream, DA for prolactinoma, CAB, showed no change in BP, except for a decrease in diastolic BP only among female patients after a 6-month follow-up. However, low BP is a classical side effect of CAB.…”

Autoimmune Thyroiditis Attenuates Cardiometabolic Effects of Cabergoline in Young Women With Hyperprolactinemia

“…1,2 It has been found that long-term prolactin excess may be complicated by insulin resistance, hyperinsulinemia, overweight/obesity, systemic inflammation, increased procoagulant activity, impaired flow-mediated dilatation of the brachial artery, and increased propagation speed of the pulse wave in the arteries. [3][4][5][6][7] These adverse metabolic disturbances and proatherosclerotic effects may be reversed or alleviated by dopaminergic agents, [7][8][9] the drugs of choice in the treatment of prolactin excess. 10 It seems that cabergoline is not only better tolerated and more convenient in administration, 10 but also superior to bromocriptine when it comes to affecting insulin sensitivity, atherogenic dyslipidemia, and circulating levels of cardiovascular risk factors in women with prolactin excess.…”