Serum Prolactin in Advanced Chronic Liver Disease

C. Ress; P.-A. Maeser; A. Tschoner; L. Loacker; K. Salzmann; G. Staudacher; A. Melmer; H. Zoller; W. Vogel; A. Griesmacher; H. Tilg; I. Graziadei; S. Kaser

doi:10.1055/s-0034-1375612

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2014; 46(11): 800-803
DOI: 10.1055/s-0034-1375612

Endocrine Care

Serum Prolactin in Advanced Chronic Liver Disease

Authors

C. Ress

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
P.-A. Maeser

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
A. Tschoner

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
L. Loacker

²Central Institute for Medical and Chemical Laboratory Diagnostics, Medical University Innsbruck, Innsbruck, Austria
K. Salzmann

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
G. Staudacher

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
A. Melmer

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
H. Zoller

³Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
W. Vogel

³Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
A. Griesmacher

²Central Institute for Medical and Chemical Laboratory Diagnostics, Medical University Innsbruck, Innsbruck, Austria
H. Tilg

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
I. Graziadei

³Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria

⁴Division of Internal Medicine, Hospital Hall in Tirol, Hall, Austria
S. Kaser

¹Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria

Abstract

Hyperprolactinemia is a frequent endocrine disorder with well known harmful effects on the reproductive system and bone metabolism. Besides prolactinomas several drugs and disorders such as renal failure and hypothyroidism have been shown to cause hyperprolactinemia. Based on former studies, liver cirrhosis has also been suggested to cause hyperprolactinemia, while mechanisms have not been identified yet. In this study, we set out to investigate the prevalence and predictors of hyperprolactinemia in 178 patients with liver cirrhosis of different etiologies. Eighteen out of 178 patients – 7 females and 11 males – displayed elevated serum prolactin levels. When patients were excluded who suffered from co-morbidities or took medication that are discussed to potentially interfere with prolactin metabolism, only 3 males displayed increased serum prolactin levels. Prolactin levels were similar in patients with liver cirrhosis of different etiologies. Our data suggest that hyperprolactinemia is not commonly found in patients with liver cirrhosis, but is mostly associated with intake of drugs or presence of comorbidites which are known to potentially cause hyperprolactinemia. We thus hypothesize that in contrast to former studies liver cirrhosis is not a common cause of hyperprolactinemia and that in the absence of co-morbidities or drugs that are known to potentially increase prolactin levels, marked hyperprolactinemia needs further investigation in patients with liver cirrhosis.

Key words

prolactin - liver cirrhosis - Child–Pugh score

Volltext

Referenzen

References
1 Klibanski A. Clinical practice. Prolactinomas. N Engl J Med 2010; 362: 1219-1226
2 Burra P. Liver abnormalities and endocrine diseases. Best Pract Res Clin Gastroenterol 2013; 27: 553-563
3 Ninkovic M, Love SA, Tom B, Alexander GJ, Compston JE. High prevalence of osteoporosis in patients with chronic liver disease prior to liver transplantation. Calcif Tissue Int 2001; 69: 321-326
4 Compston JE. Osteoporosis after liver transplantation. Liver Transpl 2003; 9: 321-330
5 Morgan MY, Jakobovits AW, Gore MB, Wills MR, Sherlock S. Serum prolactin in liver disease and its relationship to gynaecomastia. Gut 1978; 19: 170-174
6 Zietz B, Lock G, Plach B, Drobnik W, Grossmann J, Scholmerich J, Straub RH. Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis. Eur J Gastroenterol Hepatol 2003; 15: 495-501
7 De A, Boyadjieva N, Pastorcic M, Sarkar D. Potentiation of the mitogenic effect of estrogen on the pituitary-gland by alcohol-consumption. Int J Oncol 1995; 7: 643-648
8 Sengupta A, Sarkar DK. Roles of dopamine 2 receptor isoforms and g proteins in ethanol regulated prolactin synthesis and lactotropic cell proliferation. PloS One 2012; 7: e45593
9 Murdoch FE, Byrne LM, Ariazi EA, Furlow JD, Meier DA, Gorski J. Estrogen receptor binding to DNA: affinity for nonpalindromic elements from the rat prolactin gene. Biochemistry 1995; 34: 9144-9150
10 Malayer JR, Gorski J. The role of estrogen receptor in modulation of chromatin conformation in the 5′ flanking region of the rat prolactin gene. Mol Cell Endocrinol 1995; 113: 145-154
11 Gordon GG, Olivo J, Rafil F, Southren AL. Conversion of androgens to estrogens in cirrhosis of the liver. J Clin Endocrinol Metab 1975; 40: 1018-1026
12 Seehofer D, Steinmueller T, Graef KJ, Rayes N, Wiegand W, Tullius SG, Settmacher U, Neuhaus P. Pituitary function test and endocrine status in patient with cirrhosis of the liver before and after hepatic transplantation. Ann Transplant 2002; 7: 32-37
13 Velissaris D, Karanikolas M, Kalogeropoulos A, Solomou E, Polychronopoulos P, Thomopoulos K, Labropoulou-Karatza C. Pituitary hormone circadian rhythm alterations in cirrhosis patients with subclinical hepatic encephalopathy. World J Gastroenterol 2008; 14: 4190-4195
14 Sadideen H, Swaminathan R. Macroprolactin: what is it and what is its importance?. Int J Clin Pract 2006; 60: 457-461
15 Madhusoodanan S, Parida S, Jimenez C. Hyperprolactinemia associated with psychotropics – a review. Hum Psychopharmacol 2010; 25: 281-297
16 Mertens B, Vanderheyden P, Michotte Y, Sarre S. Direct angiotensin II type 2 receptor stimulation decreases dopamine synthesis in the rat striatum. Neuropharmacology 2010; 58: 1038-1044
17 Mediskou P, Yavropoulou MP, Kotsa K, Tsekmekidou X, Psarakou-Gotzamani A, Papazisi A, Chlorou A, Yovos JG. The renin-angiotensin-aldosterone axis in patients with nontumoral [corrected] hyperprolactinemia. Clin Endocrinol 2011; 74: 306-311
18 Farthing MJ, Green JR, Edwards CR, Dawson AM. Progesterone, prolactin, and gynaecomastia in men with liver disease. Gut 1982; 23: 276-279
19 Chahal J, Schlechte J. Hyperprolactinemia. Pituitary 2008; 11: 141-146
20 Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, Wass JA, Endocrine S. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 273-288
21 Bernichtein S, Touraine P, Goffin V. New concepts in prolactin biology. J Endocrinol 2010; 206: 1-11
22 Ignacak A, Kasztelnik M, Sliwa T, Korbut RA, Rajda K, Guzik TJ. Prolactin–not only lactotrophin. A “new” view of the “old” hormone. J Physiol Pharmacol 2012; 63: 435-443
23 Olazabal IM, Munoz JA, Rodriguez-Navas C, Alvarez L, Delgado-Baeza E, Garcia-Ruiz JP. Prolactin’s role in the early stages of liver regeneration in rats. J Cell Physiol 2009; 219: 626-633
24 Kloehn S, Otte C, Korsanke M, Arendt T, Clemens A, Glasow A, Bornstein SR, Folsch UR, Monig H. Expression and distribution of the prolactin receptor in normal rat liver and in experimental liver cirrhosis. Horm Metab Res 2001; 33: 394-401
25 Simon-Holtorf J, Monig H, Klomp HJ, Reinecke-Luthge A, Folsch UR, Kloehn S. Expression and distribution of prolactin receptor in normal, fibrotic, and cirrhotic human liver. Exp Clin Endocrinol Diabetes 2006; 114: 584-589
26 Biller BM. Diagnostic evaluation of hyperprolactinemia. J Reprod Med 1999; 44: 1095-1099
27 George J, Ganesh HK, Acharya S, Bandgar TR, Shivane V, Karvat A, Bhatia SJ, Shah S, Menon PS, Shah N. Bone mineral density and disorders of mineral metabolism in chronic liver disease. World J Gastroenterol 2009; 15: 3516-3522
28 Fahie-Wilson MN, Soule SG. Macroprolactinaemia: contribution to hyperprolactinaemia in a district general hospital and evaluation of a screening test based on precipitation with polyethylene glycol. Ann Clin Biochem 1997; 34: 252-258
29 Olukoga AO, Kane JW. Macroprolactinaemia: validation and application of the polyethylene glycol precipitation test and clinical characterization of the condition. Clin Endocrinol 1999; 51: 119-126
30 Shimatsu A, Hattori N. Macroprolactinemia: diagnostic, clinical, and pathogenic significance. Clin Dev Immunol 2012; 2012: 167132
31 Lim VS, Kathpalia SC, Frohman LA. Hyperprolactinemia and impaired pituitary response to suppression and stimulation in chronic renal failure: reversal after transplantation. J Clin Endocrinol Metab 1979; 48: 101-107