Endocrine Abstracts

Background : Obesity is a chronic and complex health problem. Although it is a preventable health risk factor, it´s prevalence has grown rapidly in recent years. There are studies that demonstrate the relationship between hyperprolactinemia and obesity. However, it is not well explained and the results are contradictory. The objective of this study was to evaluate the relationship between increased prolactin and Body Mass Index (BMI) in patients with pituitary macroadenomas.

Methods: A retrospective case-control study was carried out by extracting information from medical records of patients with non-functioning macroadenomas and macroprolactinomas, taking into account the difference in prolactin level due to their functionality; excluding other lesions of the sella turcica. The study population was under hormonal supplementation of the affected axis in the case of have it. Descriptive statistics and subsequent odds ratio analysis were performed.

Results: 112 patients were included, of which 44 were prolactinomas and 68 non-functioning adenomas, with no significant difference between gender. The current mean age was 44.29 years (SD 15.77), the average BMI 29.59 Kg/m2 (SD 5.11), the mean tumor size was 32.53 mm (10 to 75). Mean prolactin values measured in non-functioning adenomas were 34 ng/mL (2 to 111) and prolactinomas 5800 ng/mL (217 to 47,000). 44.7% of the sample had a BMI greater than 30 kg/m2. In the Odds Ratio analysis we obtained a value of 1.636 (interval 0.774-3.576) indicating that there is no relationship between the amount of prolactin and the risk of developing obesity.

Conclusion : Despite previous evidence demonstrating a relationship between prolactin and obesity risk due to changes in the functionality of adipose tissue, lipid metabolism, insulin resistance and hypothalamic cathepsin and kisspeptin secretion. In this study, relating two populations with similar characteristics in terms of gender, tumor size, and age, we found that the increase in prolactin was not related to having a greater risk of obesity. Taking into account that in our general population 19.93% have obesity (ENSANUT 2018), in our universe 44.7% present this condition. Due to the findings of a higher BMI in the population with the presence of a sellar lesion, we recommend weight approaches in the population group studied, regardless of their functionality.

Keywords: Pituitary adenoma, prolactinoma, hyperprolactinemia, obesity