我们对多囊卵巢综合征催乳素水平异常低了解多少?叙述性综述。

IF 6.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-10-19 DOI:10.1007/s11154-024-09912-x
Nicoletta Cera, Joana Pinto, Duarte Pignatelli
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引用次数: 0

摘要

高泌乳素血症和低泌乳素血症似乎与多囊卵巢综合症患者发生代谢改变有关。相反,在泌乳素水平明显升高和明显降低之间,泌乳素似乎对代谢后果具有保护作用。在本综述中,我们发现有 4 项研究调查了多囊卵巢综合症患者的低泌乳素血症。我们还发现另外 6 项研究报告了多囊卵巢综合症患者的低泌乳素水平。虽然其发病率并不高(13.2%-13.9%),但它对多囊卵巢综合症患者的代谢改变(胰岛素抵抗、肥胖、糖尿病和脂肪肝)肯定有重大影响。多巴胺可抑制催乳素和促肾上腺皮质激素的分泌。如果多巴胺水平较低或多巴胺受体表达较少或发生突变,催乳素和 GnRH 的水平就会升高,LH 也会随之升高。另一方面,高泌乳素血症(泌乳素瘤的典型水平)通过抑制吻肽(kisspeptin)发挥作用,导致 GnRH 受抑制和性腺功能减退。在多巴胺受体激动剂治疗过度导致低泌乳素血症的情况下,必须减少剂量,以尽量降低泌乳素水平。然而,目前还缺乏证实这些假设的前瞻性研究,也缺乏针对多囊卵巢综合征患者高泌乳素和低泌乳素的适当药物的随机临床试验。
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What do we know about abnormally low prolactin levels in polycystic ovary syndrome? A narrative review.

Hyper and hypoprolactinemia seem to be related to the occurrence of metabolic alterations in PCOS patients. In contrast, between significantly elevated and significantly low, prolactin levels seem to be protective against metabolic consequences. In the present review, we found 4 studies investigating hypoprolactinemia in patients with PCOS. We also identified 6 additional studies that reported low levels of PRL in PCOS patients. Although its prevalence is not considered high (13.2-13.9%), its contribution is certainly significant to the metabolic alterations observed in PCOS (insulin resistance, obesity, diabetes mellitus, and fatty liver disease). Dopamine inhibits the secretion of prolactin and GnRH. If dopamine levels are low or the dopamine receptor is less expressed or mutated, the levels of prolactin and GnRH increase, and consequently, LH also increases. On the other hand, hyperprolactinemia, in prolactinomas-typical levels, acting through kisspeptin inhibition causes GnRH suppression and hypogonadotropic hypogonadism. In situations of hypoprolactinemia due to excessive dopamine agonist treatment, dosage reduction is important to minimize the decrease in prolactin levels. Nevertheless, there is a lack of prospective studies confirming these hypotheses, as well as randomized clinical trials with appropriate drugs targeting both hyperprolactin and hypoprolactin in patients with PCOS.

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来源期刊
Reviews in Endocrine & Metabolic Disorders
Reviews in Endocrine & Metabolic Disorders 医学-内分泌学与代谢
CiteScore
14.70
自引率
1.20%
发文量
75
审稿时长
>12 weeks
期刊介绍: Reviews in Endocrine and Metabolic Disorders is an international journal dedicated to the field of endocrinology and metabolism. It aims to provide the latest advancements in this rapidly advancing field to students, clinicians, and researchers. Unlike other journals, each quarterly issue of this review journal focuses on a specific topic and features ten to twelve articles written by world leaders in the field. These articles provide brief overviews of the latest developments, offering insights into both the basic aspects of the disease and its clinical implications. This format allows individuals in all areas of the field, including students, academic clinicians, and practicing clinicians, to understand the disease process and apply their knowledge to their specific areas of interest. The journal also includes selected readings and other essential references to encourage further in-depth exploration of specific topics.
期刊最新文献
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