ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Correlation Between Serum Prolactin and the Systemic Immune-Inflammation 1 Index in Diabetic Kidney Disease: A Cross-Sectional Study
Provisionally accepted
Yinhui Li1
Zhonghao Qin1Tian Si1
Shijie Wu1
Haichao Wang1
Hanjie Yu1Kaimin Wang1Lei Yang2
Ai Peng1
Minghao Kong1*
Ling Wang1*- 1Tongji University School of Medicine,, Shanghai Tenth People's Hospital, Shanghai, China
- 2The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Abstract 30 Objective: Prolactin (PRL) is increasingly recognized as a pleiotropic hormone with potent 31 immunoregulatory properties; however, its involvement in systemic inflammation among 32 diabetic kidney disease (DKD) patients has not been defined. This study aimed to investigate 33 the potential association between serum PRL levels and micro-inflammation in patients with 34 DKD. 35 Methods: In this cross-sectional investigation, 994 patients with type 2 diabetes mellitus 36 (T2DM)-associated DKD were enrolled. Multivariable linear mixed-effects models were used 37 to quantify the relationship between serum PRL and the systemic immune-inflammation index 38 (SII) and other clinical parameters. Restricted cubic spline (RCS) analyses were fitted to test 39 for non-linearity, and stratified and sensitivity analyses were performed to assess robustness. 40 Results: The median serum PRL level was 344.40 mIU/L (interquartile range: 258.80–463.10). 41 After multivariable adjustment, serum PRL were positively associated with white blood cell 42 count, neutrophil count, serum ferritin, serum phosphorus and intact parathyroid hormone 43 (iPTH) levels, and inversely associated with serum albumin. For every 100 mIU/L increase in 44 serum PRL, the SII increased by an average of 7.10 units (95% CI: 3.13 to 11.07; p = 5.12 × 45 10⁻⁴). Stratified and sensitivity analyses confirmed the robustness of this association. RCS 46 analysis revealed a significant nonlinear relationship between serum PRL and SII (p for 47 nonlinearity = 0.002), with an inflection point at 282.85 mIU/L. PRL levels above this inflection 48 point showed a significant positive association with SII, whereas levels below it showed a 49 negative association. 50 Conclusion: In patients with DKD, serum PRL exhibits an independent, nonlinear association 51 with SII, characterized by a threshold around 282.85 mIU/L. This finding suggests that PRL 52 may be linked to the dysregulated immune-inflammation axis in DKD, warranting further 53 mechanistic and longitudinal investigation.
Keywords: Cross-sectional investigation, Diabetic kidney disease, Micro-inflammation, Prolactin, systemic immune-inflammation index
Received: 23 Dec 2025; Accepted: 13 Feb 2026.
Copyright: © 2026 Li, Qin, Si, Wu, Wang, Yu, Wang, Yang, Peng, Kong and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Minghao Kong
Ling Wang
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