Hyperprolactinemia may lead to bone loss, both due to hypogonadism and other hormonal disturbances.
Aim: Aim of the study was the analysis of influences of hormonal profiles associated with hyperprolactinemia on bone mineral density (BMD) and bone turnover in women with hyperprolactinemia of various origin. The subjects were 32 patients with prolactinoma, 43 ones with functional hyperprolactinemia and 29 healthy controls. All of them were studied BMD (lumbar spine, proximal femur, forearm, total body) using DXA; bone turnover markers (BAC, OC, ICTP) and hormones levels (prolactin, estradiol, LH, FSH, SHBG, testosterone, DHEA-S and i-PTH) using Spearmans correlation analysis and multiple regression analysis model. Correlations revealed the anabolic influence of PTH on lumbar spine in women with prolactinoma, and on ultradistal radius in functional hyperprolactinemia. DHEA-S correlated positively, and SHBG negatively with ICTP in prolactinoma patients. In multiple regression analysis, estradiol had greatest influence on lumbar spine and total body BMD. Moreover, positive influence of testosterone, SHBG on spine BMD, and of estradiol, testosterone, SHBG and DHEA-S on total body BMD were observed in patients with prolactinoma. LH had positive, FSH and estradiol negative influences on BAP, LH had positive and estradiol, testosterone and FSH negative influences on OC in patients with prolactinoma.
Conclusion: Hormonal disturbances associated with hyperprolactinemia influence both bone mineral density and bone turnover more in patients with prolactinoma than these with functional hyperprolactinemia.