Treatment of hyperprolactinaemia reduces total cholesterol and LDL in patients with prolactinomas

Abstract

Previous studies suggest that hyperprolactinaemia might have adverse effects on lipid and glucose metabolism. We therefore aimed to evaluate whether dopamine agonist treatment with cabergoline has significant effects on blood lipids, fasting glucose and HbA1c levels in patients with micro- or macroprolactinoma. In this retrospective observational study the main outcome measures are changes in parameters of glucose and lipid metabolism compared at hyperprolactinaemia and after achievement of normoprolactinaemia by cabergoline treatment. We enrolled 53 study participants (22 females; median [interquartile range] age: 40.0 [27.5 to 50.0] years), 22 (41.5 %) with micro-, and 31 (58.5 %) with macroprolactinomas. After a median follow-up of 9 months, prolactin levels decreased from 220.6 (80.7–913.4) to 11.2 (3.5–18.7) ng/mL (p < 0.001). There was a significant decrease in median levels of low-density lipoprotein (LDL) from 121.6 (±39.4) to 110.6 mg/dl (±37.6, p = 0.005) and total cholesterol from 191 (168.5–241) to 181 mg/dl (162–217, p < 0.001), but no change in high-density lipoprotein (HDL), triglycerides, fasting glucose and HbA1c. We observed a significant increase in testosterone in men and in oestradiol in women. In linear regression analyses using the change in total cholesterol or LDL as dependent, and the change in prolactin, oestradiol, and testosterone as independent variables, no significant predictor of the change in total cholesterol or LDL was identified. In patients with prolactinomas, normalisation of elevated prolactin levels by cabergoline treatment was accompanied by significant reductions in LDL and total cholesterol. Further studies are warranted to confirm our findings and to evaluate the clinical implications of lipid levels in the monitoring and treatment of patients with prolactinomas.

Hyperprolactinaemia

“…DAs reduce triglycerides, fasting glucose, and LDL cholesterol in individuals with prolactinomas [127]. In contrast, in another study on prolactinoma patients offered DA demonstrated no change in fasting glucose, although significant decrease of LDL and total cholesterol were observed [128]. A report of 20 premenopausal women with prolactinoma described significant decreases in BMI, total cholesterol, and LDL following treatment with DA [129].…”

Hyperprolactinemia and the Association with All-Cause Mortality and Cardiovascular Mortality

“…Focus on increased cardiovascular risk in males with hyperprolactinemia is warranted. density lipoprotein cholesterol (LDL-C) [9][10][11][12][13]. It has been suggested that hyperprolactinemia induces hyperphagia leading to obesity [14,15], and that prolactin directly regulates enzymes involved in glucose and lipid metabolism in target organs [16].…”

Carbohydrate-rich Meals Have no Impact on Post-prandial Lipid Parameters in Indians with Subclinical and Overt Primary Hypothyroidism

“…12 Both OPH and ScH are associated with varying degrees of hyperprolactinaemia, the correction of which is associated with reduction in cholesterol levels, insulin resistance and improvement in glycaemia. [13][14][15][16] This underpins the use of dopamine agonist therapy in metabolic syndrome/type 2 diabetes. 15,16 Studies have consistently shown that restoration of euthyroidism with levothyroxine supplementation is associated with reduction in levels of triglycerides, LDL-C and apo-B levels.…”

“…[13][14][15][16] This underpins the use of dopamine agonist therapy in metabolic syndrome/type 2 diabetes. 15,16 Studies have consistently shown that restoration of euthyroidism with levothyroxine supplementation is associated with reduction in levels of triglycerides, LDL-C and apo-B levels. 17 Levothyroxine therapy has no impact on apo-A1 levels.…”