METABOLIC SYNDROME IN WOMEN WITH PROLACTINOMA IN THE POSTMENOPAUSE: PREVALENCE, CORRELATION WITH SERUM PROLACTIN LEVELS AND METABOLOMIC PROFILE

• Grant number: 24/03534-0
• Support Opportunities: Regular Research Grants
• Start date: October 01, 2024
• End date: September 30, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Andrea Glezer
• Grantee: Andrea Glezer
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Ana Maria Pita Lottenberg ; Daniela Calderaro ; Ericka Barbosa Trarbach ; Geraldo Lorenzi Filho ; Gustavo Arantes Rosa Maciel ; Jarlei Fiamoncini ; Simão Augusto Lottenberg

Abstract

Hyperprolactinemia can cause hypogonadism and galactorrhea and is secondary to physiological conditions, as pregnancy and breastfeeding, or secondary to drugs, renal and hepatic failure, primary hypothyroidism and prolactinomas, among others. Prolactinomas are the most common pituitary tumors and an important cause of hypogonadism and infertility, being more frequent in women between the third and fourth decades of life.In recent decades, several studies have evaluated the effects of prolactin (PRL) on systems other than the gonadal axis, such as carbohydrate and lipid metabolism; and there was an association between hyperprolactinemia and a higher prevalence of dysglycemia, weight gain, endothelial dysfunction, unfavorable lipid profile, potentially leading to an increased risk for cardiovascular disease. Some studies have shown improvement in several laboratory parameters (elevation of HDL, reduction of triglycerides, improvement of glycemic homeostasis, and decrease of C-reactive protein levels). with the normalization of serum PRL after prolactinoma´s treatment with dopaminergic agonist (DA). DA is the gold standard treatment for hyperprolactinemia and prolactinomas.So far, there is no indication for the treatment of microprolactinomas and hyperprolactinemia in postmenopausal women, since hypogonadism is physiological at this stage of life and will occur despite hyperprolactinemia. However, if hyperprolactinemia is associated with an unfavorable metabolic/lipid profile, it is questionable whether this evidence is strength enough to support the indication of hyperprolactinemia´s treatment with DA in this population.Our study aims to evaluate clinical and laboratory parameters, including the metabolomics and imaging profile, in postmenopausal women with prolactinoma, with hyperprolactinemia, tracing a metabolic and cardiovascular risk profile; and compare the results with a control group of postmenopausal women, matched for age, body mass index, dysglycemia and dyslipidemia (AU)