Macroprolactinoma and metabolic involvement - 30/09/24
, G. Elkahla, Dr. b, A. Ben Ncir, Pr. b, B. Ben Amor, Dr. a, E. Hajji, Dr. a, I. Bayar, Dr. a, H. Marmouch, Pr. a, I. Khochtali, Pr. a, M. Darmoul, Pr. bResumen |
Introduction |
Prolactinomas are the most frequent functioning tumors of the pituitary gland. Hyperprolactinemia is associated with systemic effects like weight gain, metabolic syndrome, insulin resistance, and chronic low-grade inflammation. Some studies showed improvement in BMI, LDL and HOMA-IR after prolactin normalizing treatment.
Patients and methods |
We conducted an analytical cross-sectional study involving forty patients followed for confirmed prolactinoma. Clinical and biological data related to metabolic syndrome were collected retrospectively from the files.
Results |
Overweight or obesity was noted in 22 patients over 40 (55%). A positive correlation was detected between BMI and the size of the tumor (r=0.11) but not statistically significant (P=0.4). Six cases of prediabetes and one case of “de novo” diabetes were diagnosed on the biological assessment. For euthyroid patients, there were 4 cases of hypercholesterolemia and 3 cases of hypertriglyceridemia. For those with hypothyroidism, seven had hypercholesterolemia and 7 others had hypertriglyceridemia.
Discussion |
There is a relationship between obesity and the activity of lactotropic tumor cells. This being explained by the reduction in the availability of brain dopamine receptors and therefore dopamine which having a satietogenic effect and stimulating metabolism. Other hypotheses are mentioned like the reduction of adiponectin levels, leptin resistance and hypogonadism [1]. Excess of prolactin is also related to carbohydrate intolerance and hyperinsulinism leading to insulin resistance independently of BMI [2, 3].
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Vol 85 - N° 5
P. 415 - octobre 2024 Regresar al número
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