EFFECTS OF CABERGOLINE TREATMENT ON METABOLIC SYNDROME AND VISCERAL ADIPOSITY INDEX IN PATIENTS WITH HYPERPROLACTINEMIA.

Abstract

Introduction: Hyperprolactinemia is reportedly associated with an impaired metabolic profile, particularly in patients with concomitant hypogonadism. The current study aimed at investigating the effects of short (12 months) and long (60 months) treatment with cabergoline (CAB) on metabolic complications, metabolic syndrome (MS) prevalence and visceral adiposity index (VAI) in hyperprolactinemic patients (pts). Patients and Methods: Seventy-one pts (51 F, 20 M, aged 35.4±11.7 yrs), including 36 with microprolactinomas, 32 with macroprolactinomas and 3 with non-tumoral hyperprolactinemia, entered the study. In all pts, PRL and metabolic parameters (BMI, waist circumference, lipid and glucose profile, insulin, VAI) were assessed at diagnosis and after 12 and 60 months of continuous CAB treatment. MS was evaluated in line with NCEP-ATP III criteria. Results: Compared to baseline, CAB induced a significant decrease in PRL levels after 12 months (p=0.000) and a further decrease after 60 months (p=0.000) with complete normalization in 93% of pts. At baseline, MS prevalence was significantly higher in pts with PRL above significantly decreased after 12 (12.6%, p= 0.009) and 60 (7%, p=0.000) months of treatment compared to baseline (32.4%). Total cholesterol and triglycerides were significantly reduced after 12-month CAB compared to baseline (p=0.03), and further decreased (p=0.000) after 60-month follow-up. HDL cholesterol resulted significantly increased after 60-month CAB compared to baseline (p=0.000) and 12 months (p=0.000). Glucose and insulin significantly decreased after 12 months of CAB (p=0.001), and were further improved after long-term CAB (p=0.03 and p=0.000 respectively) compared to short-term therapy. Compared to baseline, a slight but not significant decrease in VAI was found at 12-month evaluation, whereas VAI was significantly decreased after 60 months of treatment (p=0.000). Conclusions: Short-term CAB treatment significantly improves metabolic profile, so that to reduce MS prevalence, whereas longer treatment is required to achieve a significant improvement of VAI.