Diabetic Retinopathy and Prolactin

Harter, M; Balarac, N; Pourcher, Ph.; Koslowski, James M.; Krebs, B; Ramaioli, A.

doi:10.1016/s0140-6736(76)90923-5

Cited by 13 publications

(9 citation statements)

References 2 publications

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“…The cause and significance of this finding remains unexplained. Earlier studies on serum prolactin level in relation to retinopathy in non-pregnant diabetic patients have been controversial [6,7,9]. In this study, no difference was found in prolactin levels between the patients with and without retinopathy, suggesting that serum prolactin level and diabetic retinopathy are not correlated.…”

Section: Discussioncontrasting

confidence: 65%

Metabolic control and serum hormone levels in relation to retinopathy in diabetic pregnancy

Laatikainen

Ranta

et al. 1982

Diabetologia

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Summary. The occurrence and progression of retinopathy were related to the mean blood glucose levels and the serum concentrations of prolactin, human placental lactogen, oestradiol and progesterone in 57 pregnant insulin-dependent diabetic patients. Fifteen patients had frank retinopathy, of whom eight showed a marked increase in retinopathy. The initial blood glucose levels were significantly higher in patients whose retinopathy progressed, whereas during the second and third trimester similar blood glucose levels were achieved in all groups. Serum concentrations of progesterone and human placental lactogen were significantly increased in diabetic patients during the last trimester when compared with those in normal pregnancies, and during the second trimester, patients with retinopathy showed significantly higher concentrations than those without, but no significant difference was found in oestradiol values. The eight patients with progressive retinopathy showed progesterone, human placental lactogen and oestradiol levels at or above the upper limit of the normal range. Throughout gestation, serum prolactin concentrations were significantly lower in diabetic patients than in healthy subjects. No correlation was found between serum prolactin values and the occurrence of retinopathy.Key words: Diabetes mellitus, diabetic pregnancy, diabetic retinopathy, metabolic control, human placental lactogen, progesterone, oestradiol, prolactin.Progression of diabetic retinopathy has been reported in 3%-29% of diabetic pregnancies [I, 3, 10, 11]. The main factors responsible for diabetic retinopathy are thought to be metabolic. During pregnancy, however, an increase in diabetic vasculopathy could also be related to the rapid and marked changes that occur with advancing gestation in the serum patterns of some steroid and protein hormones. In order to establish a possible correlation between progression of retinopathy, metabolic control and the hormonal status in pregnant diabetic patients, a prospective follow-up study comparing mean blood glucose levels and serum concentrations of prolactin, human placental lactogen, oestradiol and progesterone in patients with and without retinopathy, was performed. Patients and MethodsFifty-seven pregnant patients with Type 1 (insulin-dependent) diabetes treated at the I and II Departments of Obstetrics and Gynaecology of the Helsinki University Central Hospital in [1978][1979] were included in the study. In order to achieve good diabetic control, most patients were admitted to the obstetric ward for a short stay during the first trimester, usually between weeks 8 and 12 of pregnancy. All the patients were admitted to hospital during week 24, and from week 32 until delivery. Between these admissions, the patients were seen on an out-patient basis every second week and further admitted when needed.Ophthalmological examination, including direct and indirect ophthalmoscopy and colour photography of the fundus, was performed by one of the authors at the end of the first and second trimester, ...

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Section: Discussioncontrasting

confidence: 65%

Metabolic control and serum hormone levels in relation to retinopathy in diabetic pregnancy

Laatikainen

Ranta

et al. 1982

Diabetologia

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“…Here, we show that the circulating concentration of PRL is higher in diabetic patients without retinopathy than in those with PDR. These findings indicate an inverse relationship between systemic PRL and the severity of DR and suggest that previous contradictory findings are due to the lack of DR grading and the small number of patients reported (14–17). …”

Section: Discussionmentioning

confidence: 71%

“…Studies performed over 2 decades ago reported increased (14), decreased (15), or normal (16,17) PRL levels in patients with DR. Here, we show that the circulating concentration of PRL is higher in diabetic patients without retinopathy than in those with PDR.…”

Section: Discussionmentioning

confidence: 99%

High Levels of Serum Prolactin Protect Against Diabetic Retinopathy by Increasing Ocular Vasoinhibins

et al. 2010

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OBJECTIVEIncreased retinal vasopermeability (RVP) occurs early in diabetes and is crucial for the development of sight-threatening proliferative diabetic retinopathy (DR). The hormone prolactin (PRL) is proteolytically processed to vasoinhibins, a family of peptides that inhibit the excessive RVP related to DR. Here, we investigate the circulating levels of PRL in association with DR in men and test whether increased circulating PRL, by serving as a source of ocular vasoinhibins, can reduce the pathological RVP in diabetes.RESEARCH DESIGN AND METHODSSerum PRL was evaluated in 40 nondiabetic and 181 diabetic men at various stages of DR. Retinal vasoinhibins were measured in rats rendered hyperprolactinemic by placing two anterior pituitary grafts under the kidney capsule and in PRL receptor–null mice. RVP was determined in hyperprolactinemic rats subjected to the intraocular injection of vascular endothelial growth factor (VEGF) or made diabetic with streptozotocin.RESULTSThe circulating levels of PRL increased in diabetes and were higher in diabetic patients without retinopathy than in those with proliferative DR. In rodents, hyperprolactinemia led to vasoinhibin accumulation within the retina; genetic deletion of the PRL receptor prevented this effect, indicating receptor-mediated incorporation of systemic PRL into the eye. Hyperprolactinemia reduced both VEGF-induced and diabetes-induced increase of RVP. This reduction was blocked by bromocriptine, an inhibitor of pituitary PRL secretion, which lowers the levels of circulating PRL and retinal vasoinhibins.CONCLUSIONSCirculating PRL influences the progression of DR after its intraocular conversion to vasoinhibins. Inducing hyperprolactinemia may represent a novel therapy against DR.

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“…There was no difference between Type I and Type II diabetic subjects and there was no correlation between the serum prolactin level and sexual potency within the diabetic group. Previous studies on serum prolactin level in relation to retinopathy have been controversial and the number of patients studied was small (Hunter et al, 1974;Harter et al, 1976;Froland et al, 1977). Hanssen and Torjesen (1977) reported mildly elevated serum prolactin levels in 8 patients with diabetic ketoacidosis, while serum prolactin levels were normal in patients with treated diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, high mean serum prolactin levels were reported in 10 diabetic patients without retinopathy, in contrast to 4 diabetics with retinopathy with normal prolactin levels (Hunter et al, 1974). Subsequent work did not confirm these findings (Harter et al, 1976;Froland et al, 1977). A recent study found no difference in the mean serum prolactin concentration in insulin and non-insulin treated diabetic patients, but the mean serum prolactin levels were not compared to a control population (Lester et al, 1981).…”

Section: Introductionmentioning

confidence: 93%

Hyperprolactinaemia in male diabetics

Mooradian

Morley

Billington

et al. 1985

Postgraduate Medical Journal

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Summary:We recently investigated two patients with diabetes and elevated serum prolactin levels in whom no cause of hyperprolactinaemia could be found. For this reason we measured fasting serum prolactin levels in 72 diabetic males and compared the results with those of 63 healthy males and 90 nondiabetic males attending an Impotence Cinic. The diabetic group had significantly higher serum prolactin levels (13.1 ± 0.9 ng/ml) than the two control groups (9.9 ± 0.6 ng/ml for normal males and 7.7 ± 0.3 ng/ ml for the non-diabetic impotent group). Eighteen percent of the diabetics studied had serum prolactin levels above the normal range for males (> 20 ng/mI). There was no correlation between serum prolactin levels and duration of diabetes, glycosylated haemoglobin level or presence of clinically apparent retinopathy. The correlation between serum prolactin level and fasting plasma glucose was weak though statistically significant (r = 0.26, P< 0.05).

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Diabetic Retinopathy and Prolactin

Cited by 13 publications

References 2 publications

Metabolic control and serum hormone levels in relation to retinopathy in diabetic pregnancy

Metabolic control and serum hormone levels in relation to retinopathy in diabetic pregnancy

High Levels of Serum Prolactin Protect Against Diabetic Retinopathy by Increasing Ocular Vasoinhibins

Hyperprolactinaemia in male diabetics

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