Background: Pituitary prolactin secretion is physiologically supressed by dopaminergic tonus from hypothalamus, which itself is under regulation by various hypothalamic releasing factors. We Disturbed dopaminergic tonus in patients with liver cirrhosis is suspected.
The aim of our study was to measure prolactin levels in patients with cirrhosis and to investigate the relatioship between the severity of liver disease and other clinical and laboratory parameters with prolactin levels.
Patients and methods: We investigated 114 consecutive patients (74 men, 40 women) with cirrhosis. The diagnosis of cirrhosis was based on clinical and biochemical evidence and the presence of esophageal varices and/or ascites with albumin gradient>11 g/l. Recorded variables were the routine clinical, biochemical and blood parameters, prognostic indices (Child-Pugh, MELD, variceal bleeding, portal hypertension stage) and insulin and prolactin levels.
Results: Mean age was 57 (95% CI 54.9859.08), cirrhosis was in 77.2%, 14%, 7.8% alcohol induced, cryptogenic and viral respectively. Mean Child-Pugh score was 8.0 (95% CI 7.688.48), MELD score 11.4 (95% CI 10.0512.73), 29% (95% CI 21.138.4%) of patients had history of variceal bleeding. Mean prolactin levels were 14.79 (95% CI 13.1216.45) μg/l. Patients with hepatic encefalopathy comparing to patients without encefalopathy had significantly higer levels of prolactin 19.41 vs 13.93 μg/l, P=0.017. Prolactin levels were also significantly related to ascites degree, mean prolactin levels were 11.97 vs 15.56 vs 19.99 μg/l in patients with 1st, 2nd, 3rd degree of ascites respectively. In regression analysis prolactin levels were significantly dependent on Child-Pugh score (P=0.016) or Meld score (P=0.033). We found no impact of portal hypertension stage, gender nor etiology of cirrhosis on prolactin levels.
Conclusions: Prolactin levels increase significantly with severity of liver disease particularly in patients with ascites and hepatic encefalopathy. High prolactin level could therefore be considered as a negative prognostic marker of liver cirrhosis.