Hyperprolactinemia in clinical non-functional pituitary macroadenomas: A STROBE-compliant study

Area of Science:

• Endocrinology
• Oncology
• Neurosurgery

Background:

• Hyperprolactinemia is frequently observed in patients with non-functional pituitary adenomas (NFPAs).
• The underlying mechanisms of hyperprolactinemia in NFPAs remain incompletely understood.
• Understanding these mechanisms is crucial for managing patients with NFPAs.

Purpose of the Study:

• To identify predictors of hyperprolactinemia in patients with NFPAs.
• To investigate factors influencing prolactin (PRL) normalization after treatment for NFPAs.
• To enhance the clinical management of NFPAs associated with hyperprolactinemia.

Main Methods:

• Retrospective analysis of clinical, pathological, and endocrinological data from 214 NFPA patients.
• Statistical analysis to determine independent predictors for preoperative hyperprolactinemia.
• Evaluation of factors associated with PRL normalization post-surgery, including tumor characteristics and hormone levels.

Main Results:

• Hyperprolactinemia was present in 43.5% of NFPA patients.
• Independent predictors for preoperative hyperprolactinemia included female sex, younger age, and lower serum free tetraiodothyronine (FT4) levels.
• Preoperative prolactin (PRL) level was the sole predictor for postoperative PRL normalization, with higher levels correlating to lower normalization rates.

Conclusions:

• Alternative mechanisms, such as sex/age differences and FT4 feedback, may contribute to hyperprolactinemia in NFPAs.
• Preoperative PRL levels are a significant predictor of postoperative normalization, aiding in clinical management strategies.
• Further research into the specific mechanisms is warranted to optimize treatment outcomes for NFPAs with hyperprolactinemia.