title: Microcirculation and atherothrombotic parameters in prolactinoma patients: a pilot study.
abstract: Atherothrombosis is a multifactorial process, governed by an interaction between the vessel wall, hemodynamic factors and systemic atherothrombotic risk factors. Recent in vitro, human ex vivo and animal studies have implicated the hormone prolactin as an atherothrombotic mediator. To address this issue, we evaluated the anatomy and function of various microvascular beds as well as plasma atherothrombosis markers in patients with elevated prolactin levels. In this pilot study, involving 10 prolactinoma patients and 10 control subjects, sidestream dark field (SDF) imaging revealed a marked perturbation of the sublingual microcirculation in prolactinoma patients compared to control subjects, as attested to by significant changes in microvascular flow index (2.74 ± 0.12 vs. 2.91 ± 0.05, respectively; P = 0.0006), in heterogeneity index (0.28 [IQR 0.18-0.31] vs. 0.09 [IQR 0.08-0.17], respectively; P = 0.002) and lower proportion of perfused vessels (90 ± 4.0% vs. 95 ± 3.0%, respectively; P = 0.016). In the retina, fluorescein angiography (FAG) confirmed these data, since prolactinoma patients more often have dilatated perifoveal capillaries. In plasma, prolactinoma patients displayed several pro-atherogenic disturbances, including a higher endogenous thrombin potential and prothrombin levels as well as decreased HDL-cholesterol levels. Prolactinoma patients are characterized by microvascular dysfunction as well as plasma markers indicating a pro-atherothrombotic state. Further studies are required to assess if prolactin is causally involved in atherothrombotic disease.
authors: Department of Vascular Medicine, Academic Medical Center, Room F4-145 Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. A.Q.Reuwer@amc.uva.nl
authors: Anne Q
authors: AQ
authors: Reuwer
authors: Brigitte M
authors: BM
authors: Sondermeijer
authors: Suzanne
authors: S
authors: Battjes
authors: Rogier
authors: R
authors: van Zijderveld
authors: Danka J F
authors: DJ
authors: Stuijver
authors: Peter H
authors: PH
authors: Bisschop
authors: Marcel Th B
authors: MT
authors: Twickler
authors: Joost C M
authors: JC
authors: Meijers
authors: Reinier O
authors: RO
authors: Schlingemann
authors: Erik S
authors: ES
authors: Stroes
mesh_terms: D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D015175:Prolactinoma / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology*; D011516:Prothrombin / Q000378:metabolism; D013917:Thrombin / Q000378:metabolism
chemical_list: D008076:Cholesterol, HDL; D011516:Prothrombin; D013917:Thrombin