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Serum concentrations of glucose, cholesterol and triglycerides in men with prolactinoma treated with cabergoline
Concentraciones séricas de glucosa, colesterol y triglicéridos en varones con prolactinoma tratados con cabergolina
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"documento" => "article" "crossmark" => 1 "subdocumento" => "pgl" "cita" => "Med Clin. 2016;147:465.e1-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "PDF" => 1 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Consensus statement</span>" "titulo" => "Recommendations for the diagnosis, staging and treatment of pre-malignant lesions and pancreatic adenocarcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "465.e1" "paginaFinal" => "465.e8" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Recomendaciones para el diagnóstico, la estadificación y el tratamiento de las lesiones premalignas y el adenocarcinoma de páncreas" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "<span class="elsevierStyleItalic">Source</span>: Tanaka et al.<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">6</span></a>" "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2832 "Ancho" => 2503 "Tamanyo" => 322106 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Treatment algorithm for pancreatic mucinous cystic lesions according to international guidelines.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span><span class="elsevierStyleItalic">Warning signs:</span> cystic lesion in the pancreatic head causing obstructive jaundice, solid nodules with enhancement and dilation of the main pancreatic duct greater than 10<span class="elsevierStyleHsp" style=""></span>mm.</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">b</span><span class="elsevierStyleItalic">Warning signs:</span> pancreatitis, size<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>cm, wall thickening or enhancement, diameter of the main pancreatic duct between 5 and 9<span class="elsevierStyleHsp" style=""></span>mm, unenhanced mural nodules, abrupt change of the main pancreatic duct with distal pancreatic atrophy and presence of lymphadenopathy.</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">c</span>Consider surgery in young patients without contraindications to surgery and who need prolonged follow-up.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Marta Martin-Richard, Angels Ginès, Juan Ramón Ayuso, Luis Sabater, Joan Fabregat, Ramiro Mendez, Glòria Fernández-Esparrach, Xavier Molero, Eva C. 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Other authors have associated this improvement with the favourable metabolic effect of dopamine agonists, such as bromocriptine and cabergoline (CAB) in the treatment of hyperprolactinemia.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> To date, few studies have evaluated the effect of hyperprolactinemia and its treatment in men on carbohydrate and lipid metabolism with prolactinomas.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> The aim of our study was to analyze serum glucose, cholesterol and triglycerides in a group of males with prolactinoma, and no known history of diabetes mellitus or dyslipidaemia, before and after chronic treatment with CAB. Patients were not treated with hypoglycaemic or lipid-lowering agents during the study period. A retrospective study was performed in 27 patients (age 39.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.1 years; 20 macroprolactinomas [74.1%]; body mass index 31.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.05<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>). Serum glucose, cholesterol, triglycerides, PRL, gonadotropins (FSH and LH) and testosterone were measured in all patients before and after treatment with CAB. Mean glucose, cholesterol and triglycerides serum concentrations in the time of diagnosis of prolactinoma were within reference ranges (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). CAB treatment (treatment duration 56.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>46.0 months; median cumulative dose 108<span class="elsevierStyleHsp" style=""></span>mg [interquartile range 49.5–239]) showed a reduction of PRL and an increase in serum testosterone, with no significant changes in serum gonadotropin levels (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). In addition, serum glucose, cholesterol and triglycerides levels did not change significantly (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Similarly, there was no correlation between PRL and testosterone serum concentrations with serum glucose, cholesterol and triglycerides, neither at the time of diagnosis of prolactinoma nor at the last follow-up visit.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The role of PRL on carbohydrate and lipid metabolism is not entirely clear. Some human studies have linked hyperprolactinemia with carbohydrate intolerance, hyperinsulinemia and hyperlipemia.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,4</span></a> Similarly, these changes have been described in some series of patients with prolactinomas<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>. In a recent prospective non-randomized study with a control group performed in 19 patients (18 women) with prolactinoma, significantly higher levels of serum glucose, LDL cholesterol and triglycerides were observed in the control group. These authors found a significant reduction in blood glucose, cholesterol, LDL cholesterol and triglycerides after 6 months of treatment with CAB.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> By contrast, another study of 32 men with prolactinomas showed that neither hyperprolactinemia nor its treatment with CAB were associated with significant changes in blood glucose. However, serum cholesterol and triglyceride levels decreased significantly after one year of treatment with CAB, both in hypogonadal patients treated with testosterone as well as in eugonadal patients.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> These results clearly differ from ours, in which blood glucose, cholesterol and triglyceride levels were not modified with prolonged treatment with CAB despite obtaining a significant decrease and increase in serum PRL and testosterone levels, respectively. The reason for this mismatch in results in different studies is unclear, but could be related to different variables such as age, body mass index, prevalence of hypogonadism, hormone replacement therapy with testosterone and treatment with hypoglycaemic or hypolipidemic agents, among others. In conclusion, hyperprolactinemia does not modify the glycaemic or lipid profile in our male population with prolactinoma. Also, a long-term treatment with dopamine agonists, such as CAB, has no effect on these parameters.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Iglesias P, Villabona C, Díez JJ. Concentraciones séricas de glucosa, colesterol y triglicéridos en varones con prolactinoma tratados con cabergolina. Med Clin (Barc). 2016;147:466–467.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The data represent the mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation for normally distributed variables and the median (interquartile range) for nonparametric data distribution.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Baseline (at diagnosis) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last follow-up \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Biochemistry</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Glucose (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cholesterol (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">211.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>41.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">198.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>31.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Triglycerides (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">132.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>83.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">125.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>59.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Hormone study</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PRL (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.200 (3.37–5.507) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.0 (2.9–44.2)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">***</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FSH (mU/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.2 (1.3–2.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.6 (1.6–4.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LH (mU/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.6 (1.0–3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.0 (0.9–4.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Testosterone (ng/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">263.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>161.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">365.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>155.2<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1325887.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "***" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001 vs baseline.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Laboratory parameters of the 27 male patients with prolactinomas before and after treatment with cabergoline.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "BMI and metabolic profile in patients with prolactinoma before and after treatment with dopamine agonists" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.M. 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