Does persistent hyperprolactinemia contribute to bone loss independently of estrogen deficiency in postmenopausal women?
Abstract
Objective: To evaluate bone mineral density (BMD) in postmenopausal women with prolactinoma diagnosed during the premenopausal period and to compare skeletal outcomes according to prolactin status during drug-free follow-up.
Methods: This retrospective cross-sectional single-center study included 42 postmenopausal women with prolactinoma. Patients were classified as hyperprolactinemic or normoprolactinemic based on serum prolactin levels at the last follow-up visit. BMD was assessed by dual-energy X-ray absorptiometry at the lumbar spine and femoral neck. Clinical variables were compared between groups. Correlation analysis, receiver operating characteristic (ROC) analysis, and multivariable logistic regression were performed.
Results: Lumbar spine BMD was significantly lower in hyperprolactinemic patients than in normoprolactinemic patients (0.861 ± 0.124 vs. 0.960 ± 0.129 g/cm², p = 0.022), whereas femoral neck BMD did not differ. Patients with hyperprolactinemia had longer cumulative exposure to hyperprolactinemia and required longer and higher-dose cabergoline treatment. Baseline prolactin levels were higher in patients with osteoporosis and showed potential discriminatory value for identifying osteoporosis (AUC = 0.861). Lumbar spine BMD and T-scores were inversely correlated with prolactin levels. In multivariable analysis, baseline prolactin level remained independently associated with low BMD.
Conclusion: Persistent hyperprolactinemia is associated with lower lumbar…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 42 participants or records.
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