title: Treatment of hyperprolactinaemia reduces total cholesterol and LDL in patients with prolactinomas.
abstract: Previous studies suggest that hyperprolactinaemia might have adverse effects on lipid and glucose metabolism. We therefore aimed to evaluate whether dopamine agonist treatment with cabergoline has significant effects on blood lipids, fasting glucose and HbA1c levels in patients with micro- or macroprolactinoma. In this retrospective observational study the main outcome measures are changes in parameters of glucose and lipid metabolism compared at hyperprolactinaemia and after achievement of normoprolactinaemia by cabergoline treatment. We enrolled 53 study participants (22 females; median [interquartile range] age: 40.0 [27.5 to 50.0] years), 22 (41.5 %) with micro-, and 31 (58.5 %) with macroprolactinomas. After a median follow-up of 9 months, prolactin levels decreased from 220.6 (80.7-913.4) to 11.2 (3.5-18.7) ng/mL (p < 0.001). There was a significant decrease in median levels of low-density lipoprotein (LDL) from 121.6 (±39.4) to 110.6 mg/dl (±37.6, p = 0.005) and total cholesterol from 191 (168.5-241) to 181 mg/dl (162-217, p < 0.001), but no change in high-density lipoprotein (HDL), triglycerides, fasting glucose and HbA1c. We observed a significant increase in testosterone in men and in oestradiol in women. In linear regression analyses using the change in total cholesterol or LDL as dependent, and the change in prolactin, oestradiol, and testosterone as independent variables, no significant predictor of the change in total cholesterol or LDL was identified. In patients with prolactinomas, normalisation of elevated prolactin levels by cabergoline treatment was accompanied by significant reductions in LDL and total cholesterol. Further studies are warranted to confirm our findings and to evaluate the clinical implications of lipid levels in the monitoring and treatment of patients with prolactinomas.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria. verena.schwetz@medunigraz.at.
authors.forename: Verena
authors.initials: V
authors.lastname: Schwetz
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Librizzi
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Trummer
authors.affiliation: Department of Internal Medicine, Feldbach Regional Hospital, Feldbach, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Theiler
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Stiegler
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Obermayer-Pietsch
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
mesh_terms: D000328:Adult; D000077465:Cabergoline; D002784:Cholesterol / Q000097:blood*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004873:Ergolines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications*; D015175:Prolactinoma / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D008075:Lipoproteins, HDL; D002784:Cholesterol; D000077465:Cabergoline
keywords: Hyperprolactinaemia; LDL; Lipid metabolism; Prolactinoma; Total cholesterol