About this Research Topic
From a clinical perspective, prolactin is mainly of interest in patients with hyperprolactinemia causing infertility, amenorrhea, or in case of a mass effect produced by large prolactinomas pressing on the optic chiasm.
It is still under debate whether hyperprolactinemia is associated with an increased risk of cardiovascular mortality in men. These discrepancies found in epidemiological studies may be due to different populations in terms of gender, levels of prolactin, co-morbidity, or study design. As well, the use of dopamine antagonists, which not only lowers the prolactin levels but may have independent metabolic properties of their own, lead to divergent results.
In vitro studies of adipocytes support that prolactin is involved in energy homeostasis and in concert with other factors is able to alter the metabolic activity of target tissues. The literature on the metabolic effect of prolactin cannot be reduced to a clear positive or negative metabolic effect of prolactin. It is possible that the effect of prolactin may depend on variables such as distribution of prolactin receptor isoforms and mutations, sub-cutaneous fat versus visceral fat, estrogen levels, gender, and prolactin levels, i.e. prolactin within normal range or hyperprolactinemia.
It could also be claimed that the positive metabolic effects of lowering prolactin may be due to the subsequent rise in androgens such as testosterone leading to increased muscle mass and reduced fat mass. This may explain some of the effects of lowering prolactin, but cholesterol is usually increased in response to testosterone treatment.
In conclusion, hypo- as well as hyperprolactinemia may cause adverse metabolic effects. However, evidence of the beneficial effects of treating patients with hyperprolactinemia to obtain improved metabolic status is lacking. Therefore, this Research Topic aims at collecting articles and studies on the effect of prolactin lowering drugs for improved metabolic profile in patients with hyperprolactinemia.
Keywords: hyperprolactinemia, prolactin, metabolism, drugs
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