The influences of hyperprolactinemia and obesity on cardiovascular risk markers: effects of cabergoline therapy

Abstract

These data suggest that hyperprolactinaemia is associated with insulin resistance related to increased BMI and low-grade inflammation independently of BMI. Short-term cabergoline therapy can reduce the inflammatory markers.

Different Effects of Cabergoline and Bromocriptine on Metabolic and Cardiovascular Risk Factors in Patients with Elevated Prolactin Levels

“…Cabergoline was superior to bromocriptine in affecting 2-hr post-challenge plasma glucose levels, HOMA-IR, as well as circulating levels of IGF-1, FFA, uric acid, hsCRP, homocysteine, fibrinogen and 25-hydroxyvitamin D. Our results may suggest that cabergoline is superior to bromocriptine when it comes to affecting atherogenic dyslipidaemia, insulin sensitivity and circulating levels of cardiovascular risk factors in hyperprolactinaemic patients. These findings seem to support previous observations that cabergoline may be a better treatment for patients with elevated prolactin levels than bromocriptine.Apart from oligomenorrhea, infertility, galactorrhoea, loss of libido and sexual dysfunction, long-term prolactin excess is often complicated by impaired glucose tolerance, hyperinsulinaemia, insulin resistance, atherogenic dyslipidaemia, subclinical atherosclerosis, endothelial dysfunction and weight gain [1][2][3][4][5][6][7][8]. These abnormalities may be alleviated or reversed by dopamine agonists, being the drugs of choice in the treatment of prolactin-secreting tumours and elevated prolactin levels secondary to other disorders [9].…”

“…Apart from oligomenorrhea, infertility, galactorrhoea, loss of libido and sexual dysfunction, long-term prolactin excess is often complicated by impaired glucose tolerance, hyperinsulinaemia, insulin resistance, atherogenic dyslipidaemia, subclinical atherosclerosis, endothelial dysfunction and weight gain [1][2][3][4][5][6][7][8]. These abnormalities may be alleviated or reversed by dopamine agonists, being the drugs of choice in the treatment of prolactin-secreting tumours and elevated prolactin levels secondary to other disorders [9].…”

Increased Lipid Levels Improves after Treatment with Cabergolin in Patients with Prolactinoma

“…Lipid abnormalities such as, hypercholesterolemia, hypertriglyceridemia and normal lipid profiles are reported in prolactinoma patients [14,18,19]. Some studies have suggested the influence of hyperprolactiemia on the lipid profile but the mechanism is not well established.…”

“…It is suggested that obesity is occurs secondary to the changing in hypothalamic energy metabolism [13]. But, direct relationship between high prolactin and BMI is not clear [14]. A reduction in dopaminergic tone [5,15]; leptin resistance [5]; decreased adiponectin levels [16] and hypogonadism [17] are also hypothesized to be contributing factors on weight gain in patients with prolactinoma.…”

“…Total C/ HDL C ratio, which has been approved as a new atherosclerotic risk marker for endothelial dysfunction in AACE 2012 Lipid and Atherosclerosis guidelines [20], were similar between three groups. Hypercholesterolemia may improve (21) or not [14] after treatment with DA agonists. As previously demonstrated [22][23][24], it was supported in our study that CAB therapy reduce LDL-C and increase HDL-C. Our study cohort was consisted of young, non-obese and premenauposal women without traditional cardiovasculary risk factors.…”