title: Effect of chronic cabergoline treatment and testosterone replacement on metabolism in male patients with prolactinomas.
abstract: BACKGROUND
  Hyperprolactinemia and hypogonadism are reportedly associated with an impaired metabolic profile. The current study aimed at investigating the effects of testosterone replacement and cabergoline (CAB) treatment on the metabolic profile in male hyperprolactinemic patients.
  
  
  METHODS
  Thirty-two men with prolactinomas, including 22 with total testosterone (TT) <8 nmol/l (HG, 69%) and 10 with TT >8 nmol/l (non-HG, 31%), were entered in the study. In all patients, metabolic parameters were assessed at diagnosis and after 12- and 24-month treatment.
  
  
  RESULTS
  Compared to non-HG patients, at baseline the HG patients had higher waist circumference (WC). TT significantly correlated with body mass index (BMI). Twelve-month CAB induced PRL normalization in 84%. HG prevalence significantly decreased (28%) and non-HG prevalence significantly increased (72%). Anthropometric and lipid parameters, fasting insulin (FI), insulin sensitivity index (ISI0), homeostatic model assessment of insulin secretion (HOMA-β) and homeostatic model assessment of insulin resistance (HOMA-IR) significantly improved compared to baseline. TT was the best predictor for FI. Percent change (Δ) of TT significantly correlated with ΔCholesterol, ΔWeight and ΔBMI. Compared to non-HG patients, the HG patients had a higher weight, BMI, WC and HOMA-β. In HG, testosterone replacement was started. After 24 months, PRL normalized in 97%. HG prevalence significantly decreased (6%) and non-HG prevalence significantly increased (94%). Anthropometric and lipid parameters, FI, ISI0, HOMA-β and HOMA-IR significantly improved compared to baseline, with FI, ISI0, HOMA-β and HOMA-IR further ameliorating compared to the 12-month evaluation. Compared to non-HG patients, the HG patients still had a higher weight, BMI and WC.
  
  
  CONCLUSIONS
  In hyperprolactinemic hypogonal men, proper testosterone replacement induces a significant improvement in the metabolic profile, even though the amelioration in the lipid profile might reflect the direct action of CAB.
authors.affiliation: Ios and Coleman Medicina Futura Medical Center, Università 'Federico II', Naples, Italy.
authors.forename: Renata S
authors.initials: RS
authors.lastname: Auriemma
authors.forename: Mariano
authors.initials: M
authors.lastname: Galdiero
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vitale
authors.forename: Luciana
authors.initials: L
authors.lastname: Granieri
authors.forename: Fabio
authors.initials: F
authors.lastname: Lo Calzo
authors.forename: Ciro
authors.initials: C
authors.lastname: Salzano
authors.forename: Lucia
authors.initials: L
authors.lastname: Ferreri
authors.forename: Claudia
authors.initials: C
authors.lastname: Pivonello
authors.forename: Federica
authors.initials: F
authors.lastname: Cariati
authors.forename: Giorgio
authors.initials: G
authors.lastname: Coppola
authors.forename: Cristina
authors.initials: C
authors.lastname: de Angelis
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
mesh_terms: D000328:Adult; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D004873:Ergolines / Q000008:administration & dosage / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006801:Humans; D006966:Hyperprolactinemia / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D008297:Male; D055442:Metabolome / Q000187:drug effects; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D015175:Prolactinoma / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D013739:Testosterone / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D013739:Testosterone; D000077465:Cabergoline