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Elera-Fitzcarrald C, Ugarte-Gil MF, Gamboa-Cárdenas RV, Zevallos F, Medina M, Cucho-Venegas JM, Perich-Campos RA, Alfaro-Lozano JL, Rodriguez-Bellido Z, Alarcón GS, Pastor-Asurza CA. Prolactin levels are associated with a pro-inflammatory body mass distribution among women with systemic lupus erythematosus. Lupus 2016; 26:808-814. [PMID: 27852933 DOI: 10.1177/0961203316678673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The objective of this study was to determine whether prolactin levels are associated with a pro-inflammatory body mass distribution in women with systemic lupus erythematosus (SLE). Methods This cross-sectional study was conducted in consecutive female SLE patients seen in our rheumatology department from January 2012 to July 2015. Prolactin was measured in ng/ml. Body mass distribution was measured by dual energy x-ray absorptiometry and it was divided into subtotal (whole body excluding the head), subtotal bone mineral content, lean mass index (appendicular lean mass/height2), subtotal trunk and leg fat percentages and trunk-to-leg fat ratio. The association between prolactin levels and body mass distribution components was evaluated by univariable and multivariable linear regression models adjusting for possible confounders. Results One hundred and eighty-five patients were evaluated; their mean (SD) age at diagnosis was 34.8 (13.8) years; nearly all patients were Mestizo. Patients included in this study were comparable to the rest of the cohort in terms of age, disease duration, SLEDAI, SDI and body mass index. Disease duration was 7.3 (6.6) years. The SLEDAI was 5.2 (4.3) and the SDI 0.9 (1.3). Prolactin levels were 18.9 (16.7) ng/ml. In univariable analyses, prolactin was negatively associated with bone mineral density, bone mineral content, leg fat percentage and lean mass index, and positively associated with trunk-to-leg fat ratio. In the multivariable analyses, prolactin was negatively associated with bone mineral content and positively associated with trunk-to-leg fat ratio. Conclusions Higher prolactin levels are associated with a pro-inflammatory body mass distribution in SLE patients.
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Affiliation(s)
- C Elera-Fitzcarrald
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.,2 Universidad Científica del Sur, Lima, Perú
| | - M F Ugarte-Gil
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.,2 Universidad Científica del Sur, Lima, Perú
| | - R V Gamboa-Cárdenas
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | - F Zevallos
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | - M Medina
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | - J M Cucho-Venegas
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | - R A Perich-Campos
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.,3 Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - J L Alfaro-Lozano
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | - Z Rodriguez-Bellido
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.,3 Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - G S Alarcón
- 4 School of Medicine, The University of Alabama at Birmingham, Birmingham, USA
| | - C A Pastor-Asurza
- 1 Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.,3 Universidad Nacional Mayor de San Marcos, Lima, Perú
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Prolactinoma: A Massive Effect on Bone Mineral Density in a Young Patient. Case Rep Endocrinol 2016; 2016:6312621. [PMID: 27446618 PMCID: PMC4944044 DOI: 10.1155/2016/6312621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/12/2016] [Accepted: 06/21/2016] [Indexed: 11/25/2022] Open
Abstract
This case highlights a prolactinoma in a young male, and its impact on bone health. Osteoporosis has been noted to be an issue in postmenopausal women with prolactinomas. This case shows a similar impact on bone health in a young male resulting in low bone mineral density for age based on Z-score. This case report highlights the possible mechanisms for the bone loss in the setting of prolactinoma and the need for assessing bone health in such patients. Furthermore it highlights the need for a thorough evaluation in such patients.
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De Hert M, Detraux J, Stubbs B. Relationship between antipsychotic medication, serum prolactin levels and osteoporosis/osteoporotic fractures in patients with schizophrenia: a critical literature review. Expert Opin Drug Saf 2016; 15:809-23. [PMID: 26986209 DOI: 10.1517/14740338.2016.1167873] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Using an antipsychotic medication can increase prolactin (PRL) levels, causing hyperprolactinemia (HPRL). Although the occurrence of osteoporosis within the population of patients with schizophrenia has been recognized, the precise nature of the association between antipsychotic treatment, PRL, osteoporosis, and the disease itself seems to be elusive. AREAS COVERED The aim of this review is to critically review the literature regarding the association between osteoporosis and PRL and to summarize the available evidence with respect to the impact of PRL-elevating antipsychotics on bone mineral density (BMD) and fractures in non-elderly patients with schizophrenia. EXPERT OPINION Although long-standing HPRL can have an impact on the rate of bone metabolism and, when associated with hypogonadism, may lead to decreased bone density in both female and male subjects, the relative contribution of antipsychotic-induced HPRL in bone mineral loss in patients with schizophrenia remains unclear. Methodological shortcomings of existing studies, including the lack of prospective data and the focus on measurements of BMD instead of bone turnover markers, preclude definitive conclusions regarding the relationship between PRL-raising antipsychotics and BMD loss in patients with schizophrenia. Therefore, more well conducted prospective trials of these biomarkers are necessary to establish the precise relationship between antipsychotics, PRL levels and osteoporosis/osteoporotic risk.
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Affiliation(s)
- Marc De Hert
- a Department of Neurosciences , KU Leuven - University Psychiatric Centre , Kortenberg , Belgium
| | - Johan Detraux
- a Department of Neurosciences , KU Leuven - University Psychiatric Centre , Kortenberg , Belgium
| | - Brendon Stubbs
- b Physiotherapy Department , South London and Maudsley NHS Foundation Trust , Denmark Hill, London , United Kingdom.,c Health Service and Population Research Department , Institute of Psychiatry, King's College London , London , United Kingdom
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