Endocrine Abstracts

Hyperprolactinemia is reportedly associated with impaired metabolic profile, particularly in patients with concomitant hypogonadism. The current study aimed at investigating the effects of 12 and 24 month-continuous cabergoline (CAB) treatment on metabolic profile in male hyperprolactinemic patients. Thirty-two men with prolactinomas, including 22 with testosterone < 8 nmol/l (HG, 69%) and 10 with T > 8 nmol/l (non–HG, 31%) entered the study. In all patients, metabolic parameters were assessed at diagnosis and after CAB treatment. Compared to non-HG, at baseline HG patients had higher PRL and waist circumference (WC). Testosterone significantly correlated with BMI. Metabolic syndrome (MetS) prevalence was not significantly different in HG (60%) and non-HG (45.4%). 12-month CAB induced PRL normalization in 91% of patients. HG prevalence significantly decreased (28%) and non-HG prevalence significantly increased (72%). Lipid and anthropometric parameters, as well as fasting insulin (FI), ISI₀, HOMA-beta, HOMA–IR and VAI were all significantly improved compared to baseline. Testosterone was the best predictive factor for FI. Testosterone percent change (Δ) significantly correlated with ΔCholesterol (CHO), ΔWeight and ΔBMI. Compared to non-HG, HG patients had higher weight, BMI, WC and HOMA-β. MetS prevalence did not differ in HG (33%) and non-HG (13%). In HG, testosterone replacement was started. After 24 month-CAB, PRL normalised in 97% of cases. HG prevalence significantly decreased (6%) and non-HG prevalence significantly increased (94%). Lipid and anthropometric parameters, as well as FI, ISI₀, HOMA-beta and HOMA-IR were all significantly improved compared to baseline, with FI, ISI₀, HOMA-beta and HOMA–-IR also significantly ameliorating compared to 1-year evaluation. Compared to non-HG, HG patients still had higher weight, BMI and WC. MetS prevalence did not differ in HG (11%) and non-HG (13%). In conclusion, in hyperprolactinemic hypogonal men proper replacement of testosterone deficiency induces a significant improvement in metabolic profile, even though the amelioration in lipid profile might reflect the direct action of CAB.