Effect of cabergoline on insulin sensitivity, inflammation, and carotid intima media thickness in patients with prolacti
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ORIGINAL ARTICLE
Effect of cabergoline on insulin sensitivity, inflammation, and carotid intima media thickness in patients with prolactinoma Serap Soytac Inancli • Alper Usluogullari • Yusuf Ustu • Sedat Caner • Abbas Ali Tam Reyhan Ersoy • Bekir Cakir
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Received: 6 August 2012 / Accepted: 4 December 2012 Ó Springer Science+Business Media New York 2012
Abstract The aim of this study was to evaluate the effect of Cabergoline on insulin sensitivity, inflammatory markers, and carotid intima media thickness in prolactinoma patients. Twenty-one female, newly diagnosed patients with prolactinoma were included in the study. None of the patients were treated previously. Cabergoline was given as treatment, starting with 0.5 mg/day and tapered necessarily. Blood samples were taken for prolactin, highly sensitive C-reactive protein, homocysteine, total cholesterol, low density lipoprotein (LDL) cholesterol, fasting glucose, insulin, and HOMA (homeostasis model assessment of insulin resistance) score was calculated, prior to and 6 months after starting treatment. The body mass index (BMI) was measured and carotid intima media thickness (CIMT) was evaluated for each patient prior to and 6 months after the treatment. The prolactin levels and LDL decreased significantly after cabergoline treatment. Insulin sensitivity improved independently from the decrease in prolactin levels and BMI. The significant decrease in
S. S. Inancli (&) Department of Endocrinology and Metabolism, School of Medicine, Near East University, Nicosia, Cyprus e-mail: [email protected] S. S. Inancli Hakki Boratas Cad, Kemal Sayin Apartment. No: 8 Daire 3, Girne, KKTC, Mersin 10, Turkey A. Usluogullari S. Caner A. A. Tam R. Ersoy B. Cakir Department of Endocrinology and Metabolism, Yildirim Beyazit University, Ankara Ataturk Education and Research Hospital, Ankara, Turkey Y. Ustu Department of Family Medicine, Ankara Ataturk Education and Research Hospital, Ankara, Turkey
homocysteine and hs-CRP was not related with the decrease in prolactin levels. The significant decrease in CIMT was independent from the decrease in prolactin levels, HOMA score, and BMI. Our data suggest that cabergoline treatment causes an improvement in insulin sensitivity and inflammatory markers and causes a decrease in CIMT independent from the decrease in prolactin, LDL cholesterol, and BMI. We conclude that short term cabergoline treatment can improve endothelial function independently from the changes in metabolic disturbances and inflammatory markers. Keywords Prolactinoma Carotid intima media thickness Insulin resistance Inflammation Atherosclerosis
Introduction The main role of prolactin is to ensure lactation [1]. Hyperprolactinemia causes amenorrhea, infertility, galactorrhea, radiologic vertebral fractures in women and infertility, gynecomastia, and radiologic vertebral fractures in men. These clinical outcomes result mainly from hypogonadism due to the negative effects of prolactin hormone on the gonadotropine releasing hormone pulsation. The increase
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