Search NEL Online

Journal Article 2015; 36(1): 53-58 PubMed PMID: 25789595 Citation  Keywords:  Adult, Circadian Rhythm, Comorbidity, Female, Humans, Hyperprolactinemia:blood, Polycystic Ovary Syndrome:blood, Prolactin:blood, Retrospective Studies, Young Adult,.   

OBJECTIVES: Hyperprolactinemia and polycystic ovary syndrome (PCOS) are on the list of the most frequent causes of female infertility. Both pathologies are characterized in common by several clinical features. At the same time, there are essential discrepancies in medical literature on mutual relations between PCOS and hyperprolactinemia. The objective of our study was to answer several questions, e.g. about frequency of hyperprolactinemia in PCOS patients, typical concentrations of prolactin (Prl) in PCOS patients vs women without polycystic ovaries and/or an assessment of circadian Prl level profiles vs single Prl sampling, as regards diagnostic usefulness.

METHODS: The study was retrospective analysis of medical records of female patients in whom nine (9) points daily profile of prolactinemia had been performed.

RESULTS: Prl levels appeared to be slightly higher in women without PCOS but the difference did not reach a border of statistical significance. The incidence of elevated Prl concentrations in 8:00 AM and 11:00 AM samples was higher in women without PCOS than in PCOS patients (32.0% vs 16.3% - 8:00 AM, and 8.5% vs 4.6% - 11:00 AM, respectively). Also, elevated mean daily prolactinemia, assessed as area under the curve (AUC) of Prl concentrations, was more frequent in the group of women without PCOS than in those with PCOS (22.0% vs 13.9%).

CONCLUSIONS: Polycystic overy syndrome is not associated with higher levels of Prl, measured in daily profiles. Hyperprolactinemia does not seem to be more frequent in PCOS women than in healthy subjects and it should not be considered as characteristic feature of PCOS - both are distinct clinical entities. Prolactin concentrations should be assessed in each woman with PCOS suspicion because of certain common clinical signs in both disorders. Every woman diagnosed with PCOS and hyperprolactinemia should further be examined in terms of the actual causes of hyperprolactinemia because the coexistence of these two disease entities - as distinct - is also possible....

Read abstract  Full text PDF

Journal Article 2015; 36(1): 84-90 PubMed PMID: 25789589 Citation  Keywords:  Adult, Estradiol:blood, Female, Follicle Stimulating Hormone:blood, Humans, Hydrocortisone:blood, Light, Luteinizing Hormone:blood, Melatonin:secretion, Menstrual Cycle:blood, Progesterone:blood, Prolactin:blood, Young Adult,.   

OBJECTIVE: Light is known to stimulate reproductive function in women. We here investigated the immediate effect of light on reproductive hormones, addressing the role of blue-sensitive (~480 nm) melanopsin-based photoreception mediating the non-visual effects of light.

METHODS: Sixteen healthy women attended the Institute at ~07:25 (shortly after waking; sunglasses worn) twice in 2-3 days in April-May, within days 4-10 of their menstrual cycle. During one session, a broad-spectrum white-appearing light with a superimposed peak at 469 nm was presented against 5-10 lux background; during the other session, short-spectrum red light peaked at 651 nm with similar irradiance level (~7.0 W/m², corresponds to ~1200 lux) was used. Venous blood was taken at 0, 22 and 44 minutes of light exposure to measure concentrations of follicle-stimulating hormone (FSH), luteinising hormone (LH), prolactin, estradiol, progesterone and cortisol, and saliva was sampled to measure melatonin as a recognised indicator of the spectral-specific action of light.

RESULTS: Melatonin values, as expected, were lower with white vs. red light (p=0.014), with the greatest difference at 22 minutes. Of the other hormones, only FSH concentrations differed significantly: they were mildly higher at white vs. red light (again, at 22 minutes; p=0.030; statistical analysis adjusted for menstrual cycle day and posture change [pre-sampling time seated]).

CONCLUSION: Moderately bright blue-enhanced white light, compared to matched-by-irradiance red light, transiently (within 22 minutes) and mildly stimulated morning secretion of follicle-stimulating hormone in women in mid-to-late follicular phase of their menstrual cycle suggesting a direct functional link between the light and reproductive system....

Read abstract  Full text PDF

Comparative Study 2014; 35(1): 50-57 PubMed PMID: 24625910 Citation  Keywords:  Adult, Antipsychotic Agents:pharmacology, Benzodiazepines:pharmacology, Body Mass Index, Estradiol:blood, Humans, Insulin:blood, Male, Middle Aged, Prolactin:blood, Risperidone:pharmacology, Schizophrenia:blood, Testosterone:blood, Time Factors,.   

OBJECTIVE: A sufficient amount of testosterone (T) is essential for adequate sexual functioning but also for cognitive and psychological well-being. Most recent studies have demonstrated that higher BMI and other symptoms of metabolic syndrome are associated with alterations in sex steroid hormone concentrations. Although, neuroleptics are known to cause a significant and sustained weight excess, the relationships between body mass index and the level of testosterone in psychiatric patients have not been thoroughly studied. The main purpose of the present study was to examine the correlations between testosterone, estradiol BMI, and insulin in male patients diagnosed with schizophrenia and treated with olanzapine or risperidone.

METHODS: The study included 78 males diagnosed with schizophrenia according to the DSM-IV diagnostic classification hospitalized in psychiatric inpatient units (42 on risperidone and 36 on olanzapine). The initial and final evaluation of testosterone (T), estradiol, prolactin (PRL) and insulin serum levels were performed at week 3 and 8 after the onset of the new treatment, respectively.

RESULTS: At week 3, the mean serum prolactin was markedly higher, whereas testosterone level was lower in risperidone patients compared to those treated with olanzapine. T level was negatively affected by the studied medication (risperidone), increased prolactin and a higher BMI. At week 8, the mean serum prolactin level was markedly higher in risperidone patients. Higher values of BMI and serum insulin were the most prominent factors independently associated with decreased plasma testosterone levels at that measurement point. Individual changes of T level between week 3 and 8 were positively correlated with the corresponding changes in estradiol levels.

CONCLUSIONS: T serum levels appear to be independently linked with BMI, insulin and prolactin in both investigated neuroleptics. Further research is needed to elucidate the relationship between reproductive hormones and metabolic parameters in patients with schizophrenia under neuroleptic treatment....

Read abstract  Full text PDF

Journal Article 2013; 34(3): 207-211 PubMed PMID: 23685418 Citation  Keywords:  Adult, Cohort Studies, Female, Follow-Up Studies, Galactorrhea:diagnosis, Humans, Hyperprolactinemia:diagnosis, Middle Aged, Pituitary Gland, Anterior:physiology, Pituitary Neoplasms:diagnosis, Pregnancy, Pregnancy Outcome, Prolactin:blood, Prolactinoma:d.   

OBJECTIVES: To determine the frequency of macroprolactinemia in a cohort of hyperprolactinemic women, describing 1) the association of macroprolactinemia with clinical variables and morphological changes in the pituitary gland and 2) clinical status and prolactin levels after 10 years of follow-up.

DESIGN: Blood samples were obtained from 32 patients for hormonal assessment. Treatment with cabergoline or bromocriptine was interrupted 3 months before the determination of serum prolactin and macroprolactin. Macroprolactin was measured using the polyethylene glycol (PEG) precipitation method. Computed tomography was performed in all patients.

RESULTS: The frequency of macroprolactinemia was 28.1%. In 19 patients prolactin remained elevated (persistent hyperprolactinemia). In 13, prolactin returned to normal (former hyperprolactinemia). Nine patients with PEG recovery between 40 and 50%, and the only two macroprolactinemic patients with previous hyperprolactinemia were excluded from the analysis of clinical outcomes. Only one of seven macroprolactinemic patients had an abnormal pituitary image (empty sella). None had galactorrhea.

MAIN FINDINGS: Classic symptoms of hyperprolactinemia and abnormal imaging findings are not common in patients in whom macroprolactin is the predominant form of PRL.

CONCLUSIONS: Women with hyperprolactinemia, especially if asymptomatic, should be routinely screened for macroprolactinemia. Macroprolactinemia remains stable in the long term....

Read abstract  Full text PDF

Case Reports 2012; 33(3): 298-300 PubMed PMID: 22635088 Citation  Keywords:  Aminoquinolines:administration & dosage, Disease Progression, Dopamine Agonists:administration & dosage, Female, Humans, Hyperprolactinemia:complications, Prolactin:blood, Thyroiditis, Autoimmune:complications, Young Adult, Zona Glomerulosa:immunology,.   

: Prolactin is a hormone with a multidirectional proinflammatory action. It has an anti-apoptotic effect, enhances proliferative response to antigens and mitogens, as well as enhances the production of immunoglobulins and autoantibodies. Increased prolactin levels are commonly observed in various organ and multi-organ specific autoimmune diseases. In our article, we report a case of a woman who developed progression of autoimmune thyroid disorder and developed insufficiency of the zona glomerulosa when her prolactin levels were increased. A normalization of plasma prolactin levels by quinagolide and replacement of risperidone with aripiprazole improved her clinical condition. Our study suggests that, in some patients, hyperprolactinemia may predispose to the development and progression of autoimmune disorders of endocrine glands....

Read abstract  Full text PDF

Case Reports 2011; 32(5): 616-618 PubMed PMID: 22167128 Citation  Keywords:  Adult, Amenorrhea:blood, Appetite Depressants:adverse effects, Cyclobutanes:adverse effects, Diagnosis, Differential, Female, Galactorrhea:blood, Humans, Hyperprolactinemia:blood, Prolactin:blood, Weight Gain:drug effects,.   

INTRODUCTION: Several drugs may cause hyperprolactinemia, especially antipsychotic drugs and prokynetic drugs. Serum prolactin concentrations increase within hours after acute administration of these drugs and return to normal within two to four days after cessation of chronic therapy. So far, sibutramine, a sympathomimetic drug used in the management of obesity, was not described to be associated with altered prolactin levels.

OBJECTIVE: The purpose of this study is to present a case of sibutramine-induced hiperprolactinemia.

CASE REPORT: A 38-year-old white female patient seeks medical attention complaining of weight gain (Body mass index: 35) associated with anxiety. She started sibutramine treatment and presented with amenogalactorrhea. Hyperprolactinemia was diagnosed (prolactin of 46 and 89.6 ng/mL) with normal thyroid, renal and hepatic function, and a negative pregnancy test. A sella MRI was performed and sibutramine was suspended. Prolactin levels returned to normal within 15 days of sibutramine cessation and remained normal within 90 days of follow-up, with resolution of the amenogalactorrhea syndrome.

CONCLUSION: sibutramine may be considered in differential diagnosis of drug-induced hyperprolactinemia....

Read abstract  Full text PDF

Journal Article 2009; 30(2): 221-226 PubMed PMID: 19675522 Citation  Keywords:  5' Untranslated Regions, Animals, Female, Gene Expression, Genotype, Mutation, Polymerase Chain Reaction, Polymorphism, Single Nucleotide, Prolactin:blood, Reproduction:genetics, Sequence Analysis, DNA, Swine:genetics, Thyrotropin-Releasing Hormone:metabo.   

OBJECTIVES: The recent genetics and molecular biology progress seems to be a fascinating challenge for the interdisciplinary studies on the effects of genetic changes in gene structure that causes the modification of physiological functions of many important proteins including hormones. Pig prolactin is one of the interesting hormones for this study.

AIM OF THE STUDY: The aim of the study was to analyze the mutation in 5'UTR region of the pig prolactin (PRL) gene and to evaluate the effect of this polymorphism on changes in plasma prolactin concentration.

RESULTS: It was found that only two individual groups of animals differed by the genotype in examined PRL gene locus - homozygote C/C and heterozygote C/T. PRL plasma concentration was 38.4 ng/ml (for C/T animals) or 42.7 ng/ml (for C/C animals). Animals with C/C genotyped exhibited a tendency to elevate PRL concentration as compared to the C/T group (p< 0.07).

CONCLUSIONS: This research combines the genetic, molecular and, in vivo, physiological study which allows focus on the possible relationship between the gene polymorphism and physiological status of animal....

Read abstract  Full text PDF

Comparative Study 2008; 29(6): 889-894 PubMed PMID: 19125151 Citation  Keywords:  Adolescent, Body Height, Child, Circadian Rhythm, Female, Growth Disorders:blood, Humans, Longitudinal Studies, Male, Periodicity, Prolactin:blood, Reproducibility of Results,.   

OBJECTIVES: In normal conditions, prolactin (Prl) secretion manifests a circadian pattern. So far, there have only been but few studies, concerning intrasubject variability and repeatability of the circadian Prl secretion pattern, based on pulse analysis. It seems, that macroscopic analysis based on measurement of Prl concentration at nine time points every 3 hours during 24 hours is an appropriate method to assess Prl profile for clinical purposes. The aim of the study was to assess the repeatability of that circadian Prl secretion pattern in a group of short children without hormonal disorders.

MATERIALS AND METHODS: The analysis comprised the results of two circadian Prl profiles, performed from 2 to 14 months in 23 prepubertal children (16 boys) with idiopathic short stature, aged: 10.3+/-2.4 yrs.

RESULTS: There were no statistical differences between Prl concentrations at the same time points in the two consecutive profiles, but the comparison of Prl concentrations at 8:00 gave results which were close to the border of statistical significance (p=0.055), what indicated low repeatability of measurement results at that particular time point. There were no statistical differences between the values of particular parameters in macroscopic profile analysis in the first and in the second test.

CONCLUSION: Circadian Prl profile, based on nine Prl concentration measurements, taken every 3 hours during one day, is characterized by high repeatability of the results and low intrasubject variability in children, despite the results of Prl concentration at 08:00 o'clock....

Read abstract  Full text PDF