Prolactin levels independently predict major cardiovascular events in patients with erectile dysfunction

Abstract

The physiological role of prolactin (PRL) in men is not completely clarified. We previously reported that in subjects consulting for sexual dysfunction, lower PRL plasma levels were associated with worse lipid and glycaemic profile, as well as with a higher prevalence of metabolic syndrome and arteriogenic erectile dysfunction (ED). The aim of this study was to assess possible associations between PRL levels and incident major cardiovascular events (MACE) in subjects with ED. When only subjects without pathological hyperprolactinaemia (PRL < 735 mU/L or 35 ng/mL) and pituitary diseases were considered, both unadjusted and adjusted analyses showed a significantly lower incidence of MACE in subjects with PRL levels in the highest PRL quintile (246-735 mU/L or 12-35 ng/mL) when compared with the rest of the sample. In particular, the risk of MACE was reduced by 5% (1-9%; p = 0.03) for each 10 ng/mL increment of PRL. Conversely, comparing patients with hyperprolactinaemia with matched controls, no significant difference was detected between cases and controls in MACE. In subjects at high risk for cardiovascular diseases, such as those with ED, a relatively high PRL plasma level is associated with an overall decreased chance of MACE, independently from other known risk factors.

Erectile dysfunction and central obesity: an Italian perspective

“…Accordingly, when WC was applied as a possible predictor of MACE in a sample of 1687 patients attending our unit, with a mean follow up of 4.3 ± 2.6 years,8788899091 we observed an unadjusted association between WC classes and increased MACE ( Figure 6a ). However, in a Cox regression model, after adjusting for lifestyle and Chronic Disease Score confounders, only a severe WC increment (>102 cm) still maintained an independent, significant association with MACE ( Figure 6b ).…”

Male Sexual Dysfunction and Chronic Kidney Disease

“…The clinical features may include erectile dysfunction (ED), decreased libido, infertility, gynecomastia, and reduced skeletal mass (10, 16). It has been shown that elevated circulating prolactin levels are associated with cardiovascular events in men with ED (17). This has been reproduced in a study of CKD patients, incorporating two independent cohorts of hemodialysis and CKD stage 1 to CKD stage 5-ND subjects (14).…”

Prolactin Levels, Endothelial Dysfunction, and the Risk of Cardiovascular Events and Mortality in Patients with CKD

“…For example, prolactin elevations occur in essential hypertension (10) and during the acute phase of coronary syndromes, ischemic strokes, transient ischemic attacks (11)(12)(13), and preeclampsia (14,15), playing a causative role in the heart failure that accompanies postpartum cardiomyopathy (16). Prolactin levels predicted major cardiovascular events in men with erectile dysfunction (17), and increased expression of prolactin receptors was found in advanced human atherosclerotic plaques (18). At present, little is known about the implications of hyperprolactinemia in CKD.…”