Evaluation of endothelial dysfunction in women with prolactinoma.

Abstract

Aim: Prolactinoma has been associated with impaired glucose metabolism and adverse cardiometabolic outcomes. This study aimed to evaluate the metabolic effects of hyperprolactinemia and its impact on endothelial function, as well as changes following treatment.

Methods: Twenty patients with prolactinoma and 15 age- and BMI-similar healthy controls were included. All participants underwent an oral glucose tolerance test (OGTT) to assess glucose and insulin responses. Endothelial function was evaluated using carotid intima-media thickness (CIMT) and flow-mediated dilation (FMD) measured by Doppler ultrasonography, along with echocardiographic assessment. In patients, all measurements were repeated after six months of treatment, once prolactin levels normalized.

Results: The mean age of patients was 26.9 ± 7.4 years with a BMI of 25.1 ± 5.6 kg/m². Patients had higher 120-minute glucose levels during OGTT compared to controls (105.1 ± 24.2 vs. 90.5 ± 15.9 mg/dL, p = 0.015). Following treatment, both 120-minute glucose levels and area under the curve glucose were significantly reduced (p = 0.045 and p = 0.005, respectively). Echocardiographic parameters, including systolic and diastolic function, as well as CIMT, were similar between groups and remained unchanged after treatment. In contrast, FMD was significantly lower in patients at baseline compared to controls (6.81 ± 5.22% vs. 16.8 ± 2.59%, p < 0.001) and improved after cabergoline therapy (13.18 ± 5.78%, p = 0.003), indicating endothelial dysfunction and its reversal with treatment.

Conclusion: Patients with prolactinoma exhibit increased glucose intolerance and impaired endothelial function in the absence of overt global cardiac dysfunction. These alterations appear to be reversible following treatment.