Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is associated with a complex altered hormonal profile. Functional mild hyperprolactinemia can be found in up to 25–30% of PCOS women. The aim of the study was to determine the incidence of hyperprolactinemia in PCOS patients and to correlate the prolactin values with hormonal and metabolic data.

Material and methods: The study included 25 women, diagnosed with PCOS, according to Rotterdam criteria (mean age 31.1±6.3 years), evaluated in the Clinic of Endocrinology, Timisoara, Romania, in 2012. The patients with other causes of hyperprolactinemia (drugs, hypothyroidism, etc.) were excluded. The hormonal profile (prolactin, LH, FSH, testosterone, DHEA-S) was determined using chemiluminescent microparticle immunoassays. If serum prolactin level was high, to exclude macroprolactinemia, polyethyleneglycol precipitation was used.

Results: Sixteen patients presented obesity (64%). The mean prolactin value in the study group was 55.1±84.5 ng/ml, median value: 20.3 ng/ml (normal values 5–17.4 ng/ml). Eleven cases (44%) presented elevated values of serum prolactin (mean 93.2±104.5 ng/ml, median 39.2 ng/ml, range 20.3–210 ng/ml). The mean prolactin values in hyperprolactinemic women with amenorrhea (n=7) were higher (137.4±78 ng/ml, median 41.2 ng/ml) than in those with present menses (87.1±110 ng/ml, median 37 ng/ml, P=0.4). Three of the cases with mild hyperprolactinemia (n=8) showed normal prolactin values after polyethyleneglycol precipitation. Three patients with marked increased prolactin levels (over 100 ng/ml) performed a pituitary MRI, with normal appearance of the pituitary gland. Prolactin values did not correlate with body mass index, total testosterone, DHEA-S, LH, FSH, LH/FSH, glycemia, or lipid profile.

Conclusion: In PCOS women, functional hyperprolactinemia can occur in a significant proportion. In these cases, other causes of hyperprolactinemia must be excluded (macroprolactinemia, pituitary adenoma, hypothyroidism, drugs, etc.). The prolactin levels do not correlate with other hormonal and metabolic parameters.