Lipid Profile Differences in Monomeric Hyperprolactinemia, Macroprolactinemia, and Healthy Controls: A Comparative Analysis.

Introduction: This study aimed to investigate the effects of different prolactin isoforms - specifically macroprolactin and monomeric prolactin - on lipid metabolism across various subtypes of hyperprolactinemia.

Methods: A total of 166 adults were retrospectively analyzed and categorized into macroprolactinemia, gray zone, and monomeric hyperprolactinemia (further subdivided into prolactinoma and idiopathic groups), along with a healthy control group. Lipid parameters, including total cholesterol, lipoprotein cholesterol (LDL), HDL, triglycerides, and non-HDL cholesterol, were compared among groups. Statistical analyses were adjusted for age and body mass index (BMI).

Results: Patients with prolactinoma, idiopathic hyperprolactinemia, and those in the gray zone exhibited significantly elevated total cholesterol, LDL, and non-HDL cholesterol levels compared to healthy controls (p < 0.05). There were no significant differences in lipid profiles between the macroprolactinemia group and either the healthy controls or the monomeric hyperprolactinemia groups. Serum prolactin concentrations positively correlated with LDL, triglycerides, and non-HDL cholesterol, whereas macroprolactin recovery rates showed no such associations.

Conclusion: Monomeric hyperprolactinemia - particularly in prolactinoma - is associated with dyslipidemia and potentially increased cardiovascular risk. In contrast, macroprolactinemia appears metabolically inactive or may represent an intermediate metabolic state. Differentiating prolactin isoforms are crucial for accurate clinical evaluation and appropriate metabolic risk assessment in patients with hyperprolactinemia.