Endocrinology
doi: 10.25005/2074-0581-2018-20-4-448-454
SOME ASPECTS OF METABOLIC CHANGES IN HYPERPROLACTINEMIA OF TUMOUR AND NON-TUMOUR GENESIS

Sh.S. Anvarova1, M.A. Pirma tova1, S.A. Avezov2

1Department of Endocrinology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Institute of Gastroenterology, Dushanbe, Republic of Tajikistan

Objective: SOME ASPECTS OF METABOLIC CHANGES IN HYPERPROLACTINEMIA OF TUMOUR AND NON-TUMOUR GENESIS

Methods: It has been established that in patients with hyperprolactinemia, especially with pituitary prolactinoma, there is a predisposition to the development of the osteopenic syndrome. Refinement of the study of bone tissue remodelling processes revealed the predominance of resorption processes over bone formation processes, which, as a result, leads to disruption of bone tissue microarchitectonics. The most common variant of dyslipidemia in the metabolic syndrome is the lipid triad: hypertriglyceridemia, a low level of high-density lipoproteins and an increase in the level of low-density lipoproteins.

Results: A decrease in bone density according to densitometry and changes in calcium-phosphorus metabolism were detected in 47 (36.4%) patients (40 with pituitary adenoma and 7 without adenoma). Changes in the content of ionized Ca in serum were observed in 14 (29.9%) patients of the main group. A direct correlation was found between the level of prolactin and the C-terminal telopeptide (r=0.5284; p<0.05) and the inverse relationship between prolactin and osteocalcin (r=-0.4015; p<0.05). The degree of increase in the activity of ALAT and ASAT correlated with an increased level of prolactin (r=0.758; p<0.05). The correlation between the atherogenic coefficient and the level of prolactin revealed a positive pattern (r=0.822; p<0.05). Ultrasound revealed fatty hepatosis in 52 (40%) people, of whom 45 (34.6%) had different degrees of obesity. A study of liver biopsy specimens in 9 showed that in most cases (n=7) there was a minimal or moderate degree of fatty degeneration of hepatocytes.

Conclusion: It has been established that in patients with hyperprolactinemia, especially with pituitary prolactinoma, there is a predisposition to the development of the osteopenic syndrome. Refinement of the study of bone tissue remodelling processes revealed the predominance of resorption processes over bone formation processes, which, as a result, leads to disruption of bone tissue microarchitectonics. The most common variant of dyslipidemia in the metabolic syndrome is the lipid triad: hypertriglyceridemia, a low level of high-density lipoproteins and an increase in the level of low-density lipoproteins.

Keywords: Hyperprolactinemia, osteopenia, osteoporosis, non-alcoholic fatty liver disease, insulin resistance.

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References
  1. Glezer A, Bronstein MD. Prolactinomas. Endocrinol Metab Clin North Am. 2015;44(1):71-8. Available from: http://dx.doi.org/10.1016/j. ecl.2014.11.003.
  2. Sokhadze KS, Saburov AV, Gavrilova NP. Realizatsiya programmy vspomogatel’nykh reproduktivnykh tekhnologiy u zhenshchin s giper_ prolaktinemiey i disfunktsiey shchitovidnoy zhelezy [Implementation of the assisted reproductive technology program in women with hyperprolactinemia and thyroid dysfunctions]. Fundamental’nye issledovaniya. 2013;9(4):734-43.
  3. Khodzhamurodova JA, Kosimova SI. Klinicheskie osobennosti giperprolaktinemii pri yoddefitsitnykh zabolevaniyakh [Clinical features of hyperprolactinemia in iodine deficiency diseases]. Vestnik Avitsenny [Avicenna Bulletin]. 2014;3:50-4.
  4. Glezer A, Bronstein MD. Prolactinomas, cabergoline, and pregnancy. Endocrine. 2014;47(1):64-9. Available from: http://dx.doi.org/10.1007/ s12020-014-0334-7.
  5. Kornetova EG, Mikilev FF, Lobachyova OA, Borodyuk YuN, Boyko AS, Semke AV. Klinicheskie i immunologicheskie osobennosti giperprolaktinemii u patsientov s shizofreniey, prinimayushchikh risperidon [Clinical and immunological features of hyperprolactinaemia in schizophrenic patients treated with risperidone]. Sotsial’naya i klinicheskaya psikhiatriya. 2016;26(1):5-11.
  6. Sebko TV, Kheydar LA, Koneeva SS. Giperprolaktinemiya [The hyperprolactinemia]. Rossiyskiy meditsinskiy zhurnal. 2016;22(5):250-9. Available from: http://dx.doi.org/10.18821/0869-2106-2016-22-5-250-259.
  7. Burch J, Rice S, Yang H, Neilson A, Stirk L, Francis R, et al. Systematic review of the use of bone turnover markers for monitoring the response to osteoporosis treatment: the secondary prevention of fractures, and primary prevention of fractures in high-risk groups. Health Technol Assess. 2014;18(11):1-180. Available from: http://dx.doi.org/10.3310/hta18110.
  8. Gaibov AD, Anvarova ShS, Kamolov AN, Kurbanova MO, Kalmykov EL, Sadriev ON. Nekotorye osobennosti diagnostiki i lecheniya bol’nykh s opukholyami nadpochechnikov [Some features of diagnosis and treatment of patients with adrenal tumors]. Vestnik Avitsenny [Avicenna Bulletin]. 2011;4:19-24.
  9. Ress C, Maeser PA, Tschoner A, Loacker L, Salzmann K, Staudacher G, et al. Serum prolactin in advanced chronic liver disease. Horm Metab Res. 2014;46(11):800-3. Available from: http://dx.doi. org/10.1055/s-0034-1375612.
  10. Gaffarova II, Buchneva NV. Giperprolaktinemiya. Diagnostika i lechenie [Hyperprolactinemia. Diagnosis and treatment]. Nauka i mir. 2016;2(5):47-8.
  11. Ivanova NV, Chistyakova SV, Kayotkina EV. Sovremennye predstavleniya ob etiopatogeneze sindroma «sukhogo glaza» u zhenshchin detorodnogo vozrasta pri giperprolaktinemii [Current conceptions about the etiopathogenesis of the “dry eye” syndrome in women of childbearing age with hyperprolactinemia]. Rossiyskaya detskaya oftal’mologiya. 2015;1:35-40.
  12. Moskovkina AV, Puzikova OZ, Linde VA, Rybinskaya NP. Giperprolaktinemiya u devochek-podrostkov s sindromom giperandrogenii [Hyperprolactinemia in adolescent girls with hyperandrogenism]. Detskaya bol’nitsa. 2013;2:34-9.
  13. Rykova OV. Giperprolaktinemiya: optimal’nyy algoritm laboratornoy diagnostiki [Hyperprolactinemia: optimal algorithm for laboratory diagnostics]. Zdorov’e zhenshchiny. 2016;3:126-9.
  14. Akhkubekova NK, Lubensky VV. Meditsinskaya reabilitatsiya bol’nykh s osteopenicheskim sindromom, assotsiirovannym s funktsional’noy giperprolaktinemiey, na sanatorno-kurortnom etape [Medical rehabilitation of patients with osteopenia syndrome combined with functional hyperprolactinemia at the sanatorium stage]. Kurortnaya meditsina. 2015;2:54-7.
  15. Lukyanyonok PI. Kontseptsiya dinamicheskogo nablyudeniya za patsientami s giperprolaktinemiey s pozitsiy magnitno-rezonansnoy tomografii [The concept of dynamic monitoring of patients with giperprolaktinemia from the positions of the magnetic resonance imaging]. Uspekhi sovremennogo estestvoznaniya. 2015;3:46-50.
  16. Rykova OV. Laboratornye aspekty diagnostiki giperprolaktinemii [Laboratory aspects of hyperprolactinemia diagnosis]. Mezhdunarodnyy endokrinologicheskiy zhurnal. 2015;4:55-8.

Authors' information:

Pirmatova Makhina Abdurakhimovna

Postgraduate Student, Department of Endocrinology, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (985) 401122

E-mail: m.a.pirmatova@gmail.com

Conflicts of interest: No conflict

Address for correspondence:

Pirmatova Makhina Abdurakhimovna

Postgraduate Student, Department of Endocrinology, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (985) 401122

E-mail: m.a.pirmatova@gmail.com

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