Bone density in women with prolactinoma treated with dopamine agonists.
OBJECTIVE
(1) to evaluate bone density in women with prolactinoma treated with dopamine agonists and healthy controls, using dual energy x-ray absorptiometry (DXA), (2) to classify the results according to the current International Society for Clinical Densitometry (ISCD) criteria, and (3) to correlate bone density with lean and fat masses, biochemical data and clinical aspects of prolactinomas.


METHODS
A cross-sectional study was performed in two University referral centers. Forty-five premenopausal women with prolactinoma were submitted to DXA and blood analysis (prolactin, estradiol, testosterone, SHBG, calcium, phosphorus, PTH, C-telopeptides of type 1 collagen, and osteocalcin) by the time of their clinical evaluation. They were compared with 25 control women of similar age and body mass index distribution.


RESULTS
Women with prolactinoma had lower lumbar spine Z-score than controls. Femoral neck, trochanter, and total proximal femur Z-scores were similar in patients and controls. Twenty-two percent of the patients had Z-scores below the expected age range vs. 4% in the control group. Lumbar spine, femoral neck, and total proximal femur Z-scores were mainly correlated with the amenorrhea duration. The trochanter Z-score was associated with the gynoid lean/fat mass ratio.


CONCLUSIONS
Based on the current ISCD criteria, bone density evaluation in women with prolactinoma reveals bone loss, especially of trabecular type. Bone density in these patients was particularly associated with the duration of amenorrhea, which reinforces the importance of the adequate disease control in women with prolactinoma in order to avoid complications of this disease.
Division of Endocrinology, Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Erika Cesar de Oliveira
EC
Naliato
Alice Helena Dutra
AH
Violante
Dayse
D
Caldas
Maria Lucia Fleiuss
ML
Farias
Isabela
I
Bussade
Adilson
A
Lamounier Filho
Christiane Rezende
CR
Loureiro
Rosita
R
Fontes
Yolanda
Y
Schrank
Thaissa
T
Loures
Annamaria
A
Colao
D015502:Absorptiometry, Photon; D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D001938:Brazil; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D010911:Pituitary Neoplasms / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017697:Premenopause; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012307:Risk Factors; D016896:Treatment Outcome
D015415:Biomarkers; D018491:Dopamine Agonists; D004958:Estradiol; D011388:Prolactin