Evidence-based definition of hypoprolactinemia in European men aged 40-86 years: the European male ageing study.

Autor: Han TS; Institute of Cardiovascular Research, Royal Holloway University of London, Egham, TW20 0EX, UK. thang.han@rhul.ac.uk.; Department of Endocrinology, Ashford and St Peter's NHS Foundation Trust, Chertsey, GU9 0PZ, UK. thang.han@rhul.ac.uk., Antonio L; Department of Clinical and Experimental Medicine, Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium., Bartfai G; Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary., O'Neill TW; Centre for Epidemiology Versus Arthritis, Manchester Biomedical Research Centre, The University of Manchester & NIHR, Manchester University NHS Foundation Trust, Manchester, UK., Punab M; Andrology Clinic, Tartu University Hospital, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia., Rastrelli G; Andrology, Women's Endocrinology and Gender Incongruence Unit - Careggi Teaching Hospital, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy., Maggi M; Endocrinology Unit - Careggi Teaching Hospital, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy., Słowikowska-Hilczer J; Department of Andrology and Reproductive Endocrinology, Medical University of Łódź, Łódź, Poland., Tournoy J; Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium.; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium., Vanderschueren D; Department of Clinical and Experimental Medicine, Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium., Lean MEJ; Department of Human Nutrition, University of Glasgow, Glasgow, UK., Huhtaniemi IT; Institute of Reproductive and Developmental, Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, London, UK., Wu FCW; Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Castro AI; Department of Medicine, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, , Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (IDIS), Santiago de Compostela, CB06/03, Spain., Carreira MC; Department of Medicine, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, , Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (IDIS), Santiago de Compostela, CB06/03, Spain., Casanueva FF; Department of Medicine, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, , Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (IDIS), Santiago de Compostela, CB06/03, Spain. felipe.casanueva@usc.es.
Jazyk: angličtina
Zdroj: Reviews in endocrine & metabolic disorders [Rev Endocr Metab Disord] 2024 Dec; Vol. 25 (6), pp. 1097-1107. Date of Electronic Publication: 2024 Jun 03.
DOI: 10.1007/s11154-024-09890-0
Abstrakt: Empirical evidence for a low normal or reference interval for serum prolactin (PRL) is lacking for men, while the implications of very low PRL levels for human health have never been studied. A clinical state of "PRL deficiency" has not been defined except in relation to lactation. Using data from the European Male Ageing Study (EMAS), we analyzed the distribution of PRL in 3,369 community-dwelling European men, aged 40-80 years at phase-1 and free from acute illnesses. In total, 2,948 and 2,644 PRL samples were collected during phase-1 and phase-2 (3 to 5.7 years later). All samples were analysed in the same centre with the same assay. After excluding individuals with known pituitary diseases, PRL ≥ 35 ng/ml, and PRL-altering drugs including antipsychotic agents, selective serotonin reuptake inhibitors, or dopamine agonists, 5,086 data points (2,845 in phase-1 and 2,241 in phase-2) were available for analysis. The results showed that PRL declined minimally with age (slope = -0.02) and did not correlate with BMI. The positively skewed PRL distribution was log-transformed to a symmetrical distribution (skewness reduced from 13.3 to 0.015). Using two-sigma empirical rule (2[]SD about the mean), a threshold at 2.5% of the lower end of the distribution was shown to correspond to a PRL value of 2.98ng/ml. With reference to individuals with PRL levels of 5-34.9 ng/ml (event rate = 6.3%), the adjusted risk of developing type 2 diabetes increased progressively in those with PRL levels of 3-4.9 ng/ml: event rate = 9.3%, OR (95% CI) 1.59 (0.93-2.71), and more so with PRL levels of 0.3-2.9 ng/ml: event rate = 22.7%, OR 5.45 (1.78-16.62). There was also an increasing trend in prediabetes and diabetes based on fasting blood glucose levels was observed with lower categories of PRL. However, PRL levels were not associated with cancer, cardiovascular diseases, depressive symptoms or mortality. Our findings suggest that a PRL level below 3 ng/ml (64 mlU/l) significantly identifies European men with a clinically-important outcome (of type 2 diabetes), offering a lower reference-value for research and clinical practice.
Competing Interests: Declarations. Ethical approval: Ethical approval for the study was obtained in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent Informed consent was obtained from all individual participants included in the study. Conflict of interest: There is not conflict of interest.
(© 2024. The Author(s).)
Databáze: MEDLINE
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