Prolactin effect on blood glucose and insülin in breastfeeding women

Özışık, Hatice; Süner, Aslı; Çetinkalp, Şevki

doi:10.1016/j.dsx.2019.03.045

Cited by 7 publications

(11 citation statements)

References 18 publications

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“…The studies included represent a small subset of a larger body of literature addressing the impact of breastfeeding on maternal metabolism: only studies that measured PRL and then related it directly to a maternal metabolic variable met our criteria for inclusion. Broadly, results support the concept of lactation (under the control of PRL) as a metabolic environment characterised by low circulating insulin levels, increased insulin sensitivity and low beta-cell function ( 34 , 36 , 37 ). Increased glucose concentrations post glucose load in the presence of low circulating insulin levels in healthy lactating women ensure the availability of glucose for lactose synthesis in the breast, which is not an insulin-dependent process ( 34 ).…”

Section: Discussionsupporting

confidence: 68%

“…( 31 ) found lower PRL levels at both 37 weeks’ gestation and 48 hours postpartum in women with overweight/obesity than lean controls; accompanied by significantly more delayed lactogenesis. In the three remaining studies, two reported that maternal BMI was not associated with serum PRL postpartum (regardless of lactation status ( 36 ), or in lactating women at 3-6 months postpartum ( 35 )); the third found no relationship between BMI at delivery and either pre-feed PRL or PRL response to a feed at 4-5 days postpartum ( 33 ).…”

Section: Resultsmentioning

confidence: 99%

“…Ozisik et al. ( 36 ) reported an inverse association between postpartum PRL and both HbA1c and C-peptide in a small cohort of women (n=22, 12 of whom were lactating). Harreiter et al.…”

Section: Resultsmentioning

confidence: 99%

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Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum: A systematic review and meta-analysis

et al. 2022

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ContextPre-clinical evidence suggests that prolactin has important metabolic functions in pregnancy and postpartum, in addition to lactogenic actions.ObjectiveTo explore the relationship between prolactin and maternal metabolic outcomes in human pregnancy and postpartum, particularly in relation to gestational diabetes mellitus (GDM).Data sourcesMEDLINE via OVID, CINAHL plus, Embase.Study selectionEligible studies included women who were pregnant or up to 12 months postpartum, reporting at least one maternal serum prolactin level in relation to key metabolic outcomes including GDM, glycaemic parameters, obesity, and gestational weight gain.Data extractionTwo independent reviewers extracted data.Data synthesisTwenty-six articles were included. Meta-analysis showed no relationship between maternal prolactin levels and GDM status, with a weighted mean difference of -2.14 ng/mL (95% CI -12.54 to 8.27 ng/mL, p=0.7) between GDM and controls in early pregnancy (n=3 studies) and -3.89 ng/mL (95% CI, -15.20 to 7.41 ng/mL, p=0.5) in late pregnancy (n=11 studies). In narrative synthesis of other outcomes (due to study heterogeneity and/or lack of data), prolactin levels were not associated with maternal glycaemic or weight-related parameters during pregnancy, but in the postpartum period (particularly with lactation) a high-prolactin environment was associated with low circulating insulin and beta-cell function, and increased insulin sensitivity.ConclusionsCurrent evidence from human studies does not clearly support a relationship between prolactin and metabolic parameters during pregnancy, including with GDM status. Elevated prolactin was associated with lower insulin and beta-cell function and higher insulin sensitivity in the post-partum period, but the direction of causality remains unclear.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42021262771].

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Section: Discussionsupporting

confidence: 68%

Section: Resultsmentioning

confidence: 99%

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Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum: A systematic review and meta-analysis

et al. 2022

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“…Polymorphisms in the PRL receptor were associated with gestational diabetes ( 77 ). However, other studies have demonstrated an opposite result: an inverse association between PRL and risk for gestational diabetes mellitus ( 78 , 79 ). Interestingly enough, lactation has been reported to significantly reduce the risk of metabolic syndrome, and type 2 diabetes ( 80 ).…”

Section: Insulin Resistance and Hyperglycemiamentioning

confidence: 89%

The interplay between prolactin and cardiovascular disease

et al. 2023

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Hyperprolactinemia can be caused by several conditions and its effects on the hypothalamic-pituitary-gonadal axis are understood in more detail. Nevertheless, in recent decades, other metabolic effects have been studied and data pointed to a potential increased cardiovascular disease (CVD) risk. A recent study showed a decrease in total and LDL- cholesterol only in men with prolactinoma treated with dopamine agonists (DA) supporting the previous results of a population study with increased CVD risk in men harboring prolactinoma. However, other population studies did not find a correlation between prolactin (PRL) levels and CVD risk or mortality. There is also data pointing to an increase in high-density lipoprotein levels, and decreases in triglycerides, carotid-intima-media thickness, C-reactive protein, and homocysteine levels in patients with prolactinoma on DA treatment. PRL was also implicated in endothelial dysfunction in pre and postmenopausal women. Withdrawal of DA resulted in negative changes in vascular parameters and an increase in plasma fibrinogen. It has been shown that PRL levels were positively correlated with blood pressure and inversely correlated with dilatation of the brachial artery and insulin sensitivity, increased homocysteine levels, and elevated D-dimer levels. Regarding possible mechanisms for the association between hyperprolactinemia and CVD risk, they include a possible direct effect of PRL, hypogonadism, and even effects of DA treatment, independently of changes in PRL levels. In conclusion, hyperprolactinemia seems to be associated with impaired endothelial function and DA treatment could improve CVD risk. More studies evaluating CVD risk in hyperprolactinemic patients are important to define a potential indication of treatment beyond hypogonadism.

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“… 15 16 Studies have reported that elevated PRL is associated with lower levels of glucose and lipids, as well as higher insulin sensitivity. 17 At present, it is unclear whether PRL level is correlated with plasma glucose and lipids in patients with schizophrenia taking antipsychotic drugs as part of their treatment.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of hyperprolactinemia induced by risperidone and olanzapine and their correlations with plasma glucose and lipids

Wen

Wang

et al. 2020

Gen Psych

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BackgroundHyperprolactinemia is a common adverse reaction in patients with schizophrenia who take antipsychotic drugs; it often leads to treatment non-compliance in patients and has an adverse effect on their prognosis.AimsThis study aimed to explore the risk factors of elevated prolactin (PRL) caused by risperidone (RIS) and olanzapine (OLZ) and the relationship between PRL and fasting plasma glucose and lipids.MethodsPatients with schizophrenia were divided into two groups: 264 patients who were taking RIS and 175 patients who were taking OLZ. These two groups were further divided according to serum PRL levels: an elevated PRL group (>30 ng/mL) and a normal PRL group (PRL ≤30 ng/mL). The demographics, medication dosage, fasting plasma glucose, total cholesterol and triglycerides were compared in the two groups. Logistic regression analysis was performed to explore the risk factors of elevated PRL levels.ResultsCompared with the OLZ group, the RIS group had a greater number of patients with elevated PRL (155/264 vs 58/175). Either the RIS or the OLZ group, the proportion of elevated PRL was greater in female patients (RIS: χ2=6.76, p=0.009; OLZ: χ2=12.98, p<0.001) and with higher doses of the related drugs (RIS: U=−3.73, p<0.001; OLZ: U=−2.31, p=0.021). In patients taking RIS, the elevated PRL subgroup took the drug for a longer period (U=−2.76, p=0.006) and had lower triglyceride levels (U=2.76, p=0.006). In patients taking OLZ, the elevated PRL subgroup had lower fasting plasma glucose levels (U=2.29, p=0.022). Logistic regression analysis showed that gender, dose and fasting glucose levels were significantly associated with elevated PRL levels (RIS: p=0.001, OLZ: p<0.001; RIS: p<0.001; OLZ: p=0.003; RIS: p=0.020, OLZ: p=0.001, respectively).ConclusionCompared with OLZ, RIS had a greater effect on PRL in patients with schizophrenia, and in patients with schizophrenia taking RIS or OLZ, gender and dose were significantly correlated with the PRL value. Moreover, the plasma glucose level of the group with elevated PRL was lower than that of the group with normal PRL. The results also showed that high serum PRL may be associated with a favourable glucose metabolic profile in patients with schizophrenia taking RIS or OLZ. Further studies are warranted to confirm this association.Trial registration numberNCT02640911

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Prolactin effect on blood glucose and insülin in breastfeeding women

Cited by 7 publications

References 18 publications

Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum: A systematic review and meta-analysis

Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum: A systematic review and meta-analysis

The interplay between prolactin and cardiovascular disease

Risk factors of hyperprolactinemia induced by risperidone and olanzapine and their correlations with plasma glucose and lipids

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