Reference intervals for serum prolactin concentrations: analytical and clinical considerations.
Kate Coleman1, Mohamed Saleem2,3
1SA Pathology, Adelaide, SA, 5000, Australia. kate.coleman@sa.gov.au.
Reviews in Endocrine & Metabolic Disorders
|November 19, 2024
Summary
Establishing accurate prolactin reference intervals is challenging due to assay variability and physiological factors. Harmonizing methods for macroprolactin detection is crucial for improved clinical care.
Area of Science:
- Endocrinology
- Clinical Chemistry
- Laboratory Medicine
Background:
- Prolactin, a protein from the anterior pituitary, regulates mammary gland development and milk production.
- Circulating prolactin exists in monomeric, dimeric, and macroprolactin forms, impacting assay results.
- Assay variability persists despite standardization, necessitating laboratory-specific reference intervals.
Purpose of the Study:
- To highlight the complexities in determining reliable prolactin reference intervals.
- To discuss the challenges posed by macroprolactin and assay variability.
- To emphasize the need for harmonized methods in clinical laboratories.
Main Methods:
- Review of prolactin physiology, forms, and assay standardization.
- Discussion of direct and indirect methods for reference interval determination.
- Analysis of factors influencing prolactin levels (age, sex, menopause, macroprolactin).
Main Results:
- Significant variability exists between commercial prolactin assays.
- Physiological variations and macroprolactin complicate reference interval establishment.
- Current methods for reference interval determination are often impractical or have drawbacks.
Conclusions:
- Accurate prolactin reference intervals are difficult to establish due to assay and biological variability.
- Detection and reporting of macroprolactin add complexity to reference interval determination.
- Harmonization of macroprolactin detection and reporting methods could enhance clinical care.
