title: Higher doses of cabergoline further improve metabolic parameters in patients with prolactinoma regardless of the degree of reduction in prolactin levels.
abstract: OBJECTIVE
  Currently available studies that fully analyse the metabolic parameters in patients with prolactinoma are scarce and discordant. The aim of this study was to evaluate the metabolic effects of cabergoline (CAB) treatment in patients with newly diagnosed prolactinoma in relation to disease control and CAB dosage.
  
  
  METHODS
  This is a retrospective clinical-based therapy analysis.
  
  
  METHODS
  Forty-three patients with prolactinoma (eight men, 35 women), aged 33·65 ± 11·23 years, were evaluated metabolically at baseline and after 12 months of CAB treatment.
  
  
  METHODS
  Body mass index (BMI), systolic and diastolic blood pressure, waist circumference (WC), lipid profile, haemoglobinA1c (HbA1c), glucose and insulin levels (and their areas under the curve, AUC) after an oral glucose tolerance test, homoeostasis model assessment of insulin resistance (Homa-IR) index, insulin sensitivity index (ISI) Matsuda, oral disposition index (DIo) and visceral adiposity index (VAI) were measured at baseline and after 12 months of treatment.
  
  
  RESULTS
  Twelve months of CAB reduced WC (P < 0·001), total (P = 0·001) and low-density lipoprotein \terol (P < 0·001), triglycerides (P = 0·024), fasting insulin (P < 0·001), AUCINSULIN (P < 0·001), HbA1c (P = 0·022), Homa-IR (P < 0·001) and VAI (P < 0·001), with a concomitant increase in high-density lipoprotein cholesterol (P < 0·001) and in ISI Matsuda (P < 0·001), regardless of the degree of reduction in prolactin levels. The patients receiving higher doses (>0·50 mg/week) of CAB showed lower BMI (P = 0·009), fasting insulin (P = 0·001), Homa-IR (P < 0·001) and VAI (P = 0·018) and higher ISI Matsuda (P = 0·002) and DIo (P = 0·011), compared with those on lower doses.
  
  
  CONCLUSIONS
  A significant metabolic improvement was observed in patients with prolactinoma after 12 months of CAB treatment, especially when higher doses were used, highlighting the importance of considering the metabolic profile in these patients and the role of active treatment with high CAB doses.
authors.affiliation: Section of Endocrinology, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.Mi.S), University of Palermo, Palermo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ciresi
authors.forename: Marco Calogero
authors.initials: MC
authors.lastname: Amato
authors.forename: Valentina
authors.initials: V
authors.lastname: Guarnotta
authors.forename: Flavia
authors.initials: F
authors.lastname: Lo Castro
authors.forename: Carla
authors.initials: C
authors.lastname: Giordano
mesh_terms: D050154:Adiposity / Q000187:drug effects; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004873:Ergolines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D055442:Metabolome / Q000187:drug effects; D010911:Pituitary Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D011388:Prolactin / Q000097:blood*; D015175:Prolactinoma / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D055105:Waist Circumference / Q000187:drug effects; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D018491:Dopamine Agonists; D004873:Ergolines; D008055:Lipids; D011388:Prolactin; D000077465:Cabergoline