Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment
ObjectiveControl of prolactin excess is associated with the improvement in gluco-insulinemic and lipid profile. The current study aimed at investigating the effects of pituitary surgery and medical therapy with high dose cabergoline (≥2mg/week) on metabolic profile in patients with prolactinoma resi...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:9d292f8713e946a8b0fa97cce4aec8dd2021-12-01T19:45:49ZEffects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment1664-239210.3389/fendo.2021.769744https://doaj.org/article/9d292f8713e946a8b0fa97cce4aec8dd2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.769744/fullhttps://doaj.org/toc/1664-2392ObjectiveControl of prolactin excess is associated with the improvement in gluco-insulinemic and lipid profile. The current study aimed at investigating the effects of pituitary surgery and medical therapy with high dose cabergoline (≥2mg/week) on metabolic profile in patients with prolactinoma resistant to cabergoline conventional doses (<2mg/week).DesignThirty-four patients (22 men, 12 women, aged 33.9 ± 12.5 years) with prolactinoma (4 microadenomas and 30 macroadenomas) were included in the present study. Among them 17 (50%) received pituitary surgery (PS, Group1) and 17 (50%) medical therapy with high dose cabergoline (Group 2).MethodsIn the whole patient cohort, anthropometric (weight, BMI) and biochemical (fasting glucose and insulin, triglycerides, total, HDL and LDL-cholesterol, HOMA-IR, HOMA-β and ISI0) parameters were evaluated before and within 12 months after treatment.ResultsIn Group 1, prolactin (p=0.002), total cholesterol (p=0.012), and triglycerides (p=0.030) significantly decreased after pituitary surgery compared to the baseline. Prolactin significantly correlated with fasting glucose (r=0.056, p=0.025). In Group 2, fasting insulin (p=0.033), HOMA-β (p=0.011) and ISI0 (p=0.011) significantly improved compared to baseline. Postoperative cabergoline dose significantly correlated with Δfasting glucose (r=-0.556, p=0.039) and ΔLDL cholesterol (r=- 0.521, p=0.046), and was the best predictor of ΔLDL cholesterol (r2 = 0.59, p=0.002) in Group 1.ConclusionsThe rapid decrease in PRL levels induced by PS might improve lipid metabolism, whereas HD-CAB might exert a beneficial impact on both insulin secretion and peripheral sensitivity, thus inducing a global metabolic improvement.Rosa PirchioRenata S. AuriemmaDomenico SolariMauro ArnesiClaudia PivonelloMariarosaria NegriCristina de AngelisLuigi M. CavalloPaolo CappabiancaAnnamaria ColaoAnnamaria ColaoRosario PivonelloFrontiers Media S.A.articleprolactinhyperprolactinemiapituitary neurosurgerycabergolinehigh dose cabergolineinsulin resistanceDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021) |
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prolactin hyperprolactinemia pituitary neurosurgery cabergoline high dose cabergoline insulin resistance Diseases of the endocrine glands. Clinical endocrinology RC648-665 |
| spellingShingle |
prolactin hyperprolactinemia pituitary neurosurgery cabergoline high dose cabergoline insulin resistance Diseases of the endocrine glands. Clinical endocrinology RC648-665 Rosa Pirchio Renata S. Auriemma Domenico Solari Mauro Arnesi Claudia Pivonello Mariarosaria Negri Cristina de Angelis Luigi M. Cavallo Paolo Cappabianca Annamaria Colao Annamaria Colao Rosario Pivonello Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment |
| description |
ObjectiveControl of prolactin excess is associated with the improvement in gluco-insulinemic and lipid profile. The current study aimed at investigating the effects of pituitary surgery and medical therapy with high dose cabergoline (≥2mg/week) on metabolic profile in patients with prolactinoma resistant to cabergoline conventional doses (<2mg/week).DesignThirty-four patients (22 men, 12 women, aged 33.9 ± 12.5 years) with prolactinoma (4 microadenomas and 30 macroadenomas) were included in the present study. Among them 17 (50%) received pituitary surgery (PS, Group1) and 17 (50%) medical therapy with high dose cabergoline (Group 2).MethodsIn the whole patient cohort, anthropometric (weight, BMI) and biochemical (fasting glucose and insulin, triglycerides, total, HDL and LDL-cholesterol, HOMA-IR, HOMA-β and ISI0) parameters were evaluated before and within 12 months after treatment.ResultsIn Group 1, prolactin (p=0.002), total cholesterol (p=0.012), and triglycerides (p=0.030) significantly decreased after pituitary surgery compared to the baseline. Prolactin significantly correlated with fasting glucose (r=0.056, p=0.025). In Group 2, fasting insulin (p=0.033), HOMA-β (p=0.011) and ISI0 (p=0.011) significantly improved compared to baseline. Postoperative cabergoline dose significantly correlated with Δfasting glucose (r=-0.556, p=0.039) and ΔLDL cholesterol (r=- 0.521, p=0.046), and was the best predictor of ΔLDL cholesterol (r2 = 0.59, p=0.002) in Group 1.ConclusionsThe rapid decrease in PRL levels induced by PS might improve lipid metabolism, whereas HD-CAB might exert a beneficial impact on both insulin secretion and peripheral sensitivity, thus inducing a global metabolic improvement. |
| format |
article |
| author |
Rosa Pirchio Renata S. Auriemma Domenico Solari Mauro Arnesi Claudia Pivonello Mariarosaria Negri Cristina de Angelis Luigi M. Cavallo Paolo Cappabianca Annamaria Colao Annamaria Colao Rosario Pivonello |
| author_facet |
Rosa Pirchio Renata S. Auriemma Domenico Solari Mauro Arnesi Claudia Pivonello Mariarosaria Negri Cristina de Angelis Luigi M. Cavallo Paolo Cappabianca Annamaria Colao Annamaria Colao Rosario Pivonello |
| author_sort |
Rosa Pirchio |
| title |
Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment |
| title_short |
Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment |
| title_full |
Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment |
| title_fullStr |
Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment |
| title_full_unstemmed |
Effects of Pituitary Surgery and High-Dose Cabergoline Therapy on Metabolic Profile in Patients With Prolactinoma Resistant to Conventional Cabergoline Treatment |
| title_sort |
effects of pituitary surgery and high-dose cabergoline therapy on metabolic profile in patients with prolactinoma resistant to conventional cabergoline treatment |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/9d292f8713e946a8b0fa97cce4aec8dd |
| work_keys_str_mv |
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