title: Vertebral fractures in males with prolactinoma.
abstract: Data on osteoporotic fractures in hyperprolactinemia are limited. An increased prevalence of radiological vertebral fractures was recently observed in women with prolactin (PRL)-secreting adenoma, whereas it is unknown whether this observation may reflect a more general increased risk of fractures in this disease and whether the prevalence of fractures in males is affected by gonadal status. Thirty-two males (median age 47 years, range: 22-79) with PRL-secreting pituitary adenoma (10 with microadenoma and 22 with macroadenoma) and 64 control males, with normal PRL values and with comparable age to patients with hyperprolactinemia, were evaluated for vertebral fractures by a morphometric approach and for bone mineral density (BMD) by a dual-energy X-ray absorptiometry at lumbar spine. Vertebral fractures were shown in 12 patients with PRL-secreting adenoma (37.5%) and in 5 controls (7.8%, P < 0.001). Fractured patients had lower BMD T-score (P = 0.007) and longer duration of disease (P < 0.001) as compared to patients who did not fracture. Fractures occurred more frequently (P = 0.03) in patients with untreated hyperprolactinemia versus patients treated with cabergoline whose frequency of vertebral fractures was still higher than control subjects. The prevalence of vertebral fractures was not significantly different between eugonadal and hypogonadal patients (33.3% vs. 38.5%; P = 0.8). Moreover, no significant (P = 0.4) difference in serum testosterone values was found between fractured and not fractured males. Hyperprolactinemia is associated with high prevalence of radiological vertebral fractures in men with PRL-secreting adenoma. These findings would also suggest that PRL excess may produce negative skeletal effects independently of hypogonadism.
authors.affiliation: Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy. gherardo.mazziotti@aopoma.it
authors.forename: Gherardo
authors.initials: G
authors.lastname: Mazziotti
authors.forename: Teresa
authors.initials: T
authors.lastname: Porcelli
authors.forename: Marilda
authors.initials: M
authors.lastname: Mormando
authors.forename: Ernesto
authors.initials: E
authors.lastname: De Menis
authors.forename: Antonio
authors.initials: A
authors.lastname: Bianchi
authors.forename: Carola
authors.initials: C
authors.lastname: Mejia
authors.forename: Tatiana
authors.initials: T
authors.lastname: Mancini
authors.forename: Laura
authors.initials: L
authors.lastname: De Marinis
authors.forename: Andrea
authors.initials: A
authors.lastname: Giustina
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications; D007006:Hypogonadism / Q000150:complications; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D010911:Pituitary Neoplasms / Q000150:complications*; D015175:Prolactinoma / Q000150:complications*; D016103:Spinal Fractures / Q000453:epidemiology*; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone