Morbidity and mortality in patients with hyperprolactinaemia

the PROLEARS study

Enrique Soto-Pedre (Lead / Corresponding author), Paul J. Newey, John S. Bevan, Graham P. Leese

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Abstract

Purpose: High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.

Methods: A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Record-linkage technology was used to identify patients with hyperprolactinaemia that were compared to an age-sex-matched cohort of patients free of hyperprolactinaemia. The number of deaths and incident admissions with diabetes mellitus, cardiovascular disease, cancer, breast cancer, bone fractures and infectious conditions were compared by the survival analysis.

Results: Patients with hyperprolactinaemia related to pituitary tumours had no increased risk of diabetes, cardiovascular disease, bone fractures, all-cause cancer or breast cancer. Whilst no increased mortality was observed in patients with pituitary microadenomas (HR = 1.65, 95% CI: 0.79-3.44), other subgroups including those with pituitary macroadenomas and drug-induced and idiopathic hyperprolactinaemia demonstrated an increased risk of death. Individuals with drug-induced hyperprolactinaemia also demonstrated increased risks of diabetes, cardiovascular disease, infectious disease and bone fracture. However, these increased risks were not associated with the degree of serum prolactin elevation (Ptrend > 0.3). No increased risk of cancer was observed in any subgroup.

Conclusions: No excess morbidity was observed in patients with raised prolactin due to pituitary tumours. Although the increased morbidity and mortality associated with defined patient subgroups are unlikely to be directly related to the elevation in serum prolactin, hyperprolactinaemia might act as a biomarker for the presence of some increased disease risk in these patients.

Original languageEnglish
Pages (from-to)580-588
Number of pages9
JournalEndocrine Connections
Volume6
Issue number8
DOIs
Publication statusPublished - 1 Nov 2017

Fingerprint

Hyperprolactinemia
Morbidity
Mortality
Prolactin
Bone Fractures
Breast Neoplasms
Cardiovascular Diseases
Pituitary Neoplasms
Serum
Bone Neoplasms
Scotland
Survival Analysis
Pharmaceutical Preparations
Communicable Diseases
Diabetes Mellitus
Cohort Studies
Biomarkers
Technology
Health
Population

Keywords

  • Hyperprolactinaemia
  • Prolactin
  • Pituitary gland
  • Breast cancer
  • Mortality

Cite this

@article{39d05f10765a43f28cf4d5514fb2a080,
title = "Morbidity and mortality in patients with hyperprolactinaemia: the PROLEARS study",
abstract = "Purpose: High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.Methods: A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Record-linkage technology was used to identify patients with hyperprolactinaemia that were compared to an age-sex-matched cohort of patients free of hyperprolactinaemia. The number of deaths and incident admissions with diabetes mellitus, cardiovascular disease, cancer, breast cancer, bone fractures and infectious conditions were compared by the survival analysis.Results: Patients with hyperprolactinaemia related to pituitary tumours had no increased risk of diabetes, cardiovascular disease, bone fractures, all-cause cancer or breast cancer. Whilst no increased mortality was observed in patients with pituitary microadenomas (HR = 1.65, 95{\%} CI: 0.79-3.44), other subgroups including those with pituitary macroadenomas and drug-induced and idiopathic hyperprolactinaemia demonstrated an increased risk of death. Individuals with drug-induced hyperprolactinaemia also demonstrated increased risks of diabetes, cardiovascular disease, infectious disease and bone fracture. However, these increased risks were not associated with the degree of serum prolactin elevation (Ptrend > 0.3). No increased risk of cancer was observed in any subgroup.Conclusions: No excess morbidity was observed in patients with raised prolactin due to pituitary tumours. Although the increased morbidity and mortality associated with defined patient subgroups are unlikely to be directly related to the elevation in serum prolactin, hyperprolactinaemia might act as a biomarker for the presence of some increased disease risk in these patients.",
keywords = "Hyperprolactinaemia , Prolactin, Pituitary gland, Breast cancer, Mortality",
author = "Enrique Soto-Pedre and Newey, {Paul J.} and Bevan, {John S.} and Leese, {Graham P.}",
note = "The study was supported in part by the Clinical Endocrinology Trust (UK Registered Charity Number 288679) and the NHS Tayside Research Endowments. Paul J Newey received funding from the Chief Scientist Office, UK (Fellowship SCAF/15/01).",
year = "2017",
month = "11",
day = "1",
doi = "10.1530/EC-17-0171",
language = "English",
volume = "6",
pages = "580--588",
journal = "Endocrine Connections",
issn = "2049-3614",
publisher = "BioScientifica",
number = "8",

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TY - JOUR

T1 - Morbidity and mortality in patients with hyperprolactinaemia

T2 - the PROLEARS study

AU - Soto-Pedre, Enrique

AU - Newey, Paul J.

AU - Bevan, John S.

AU - Leese, Graham P.

N1 - The study was supported in part by the Clinical Endocrinology Trust (UK Registered Charity Number 288679) and the NHS Tayside Research Endowments. Paul J Newey received funding from the Chief Scientist Office, UK (Fellowship SCAF/15/01).

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Purpose: High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.Methods: A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Record-linkage technology was used to identify patients with hyperprolactinaemia that were compared to an age-sex-matched cohort of patients free of hyperprolactinaemia. The number of deaths and incident admissions with diabetes mellitus, cardiovascular disease, cancer, breast cancer, bone fractures and infectious conditions were compared by the survival analysis.Results: Patients with hyperprolactinaemia related to pituitary tumours had no increased risk of diabetes, cardiovascular disease, bone fractures, all-cause cancer or breast cancer. Whilst no increased mortality was observed in patients with pituitary microadenomas (HR = 1.65, 95% CI: 0.79-3.44), other subgroups including those with pituitary macroadenomas and drug-induced and idiopathic hyperprolactinaemia demonstrated an increased risk of death. Individuals with drug-induced hyperprolactinaemia also demonstrated increased risks of diabetes, cardiovascular disease, infectious disease and bone fracture. However, these increased risks were not associated with the degree of serum prolactin elevation (Ptrend > 0.3). No increased risk of cancer was observed in any subgroup.Conclusions: No excess morbidity was observed in patients with raised prolactin due to pituitary tumours. Although the increased morbidity and mortality associated with defined patient subgroups are unlikely to be directly related to the elevation in serum prolactin, hyperprolactinaemia might act as a biomarker for the presence of some increased disease risk in these patients.

AB - Purpose: High serum prolactin concentrations have been associated with adverse health outcomes in some but not all studies. This study aimed to examine the morbidity and all-cause mortality associated with hyperprolactinaemia.Methods: A population-based matched cohort study in Tayside (Scotland, UK) from 1988 to 2014 was performed. Record-linkage technology was used to identify patients with hyperprolactinaemia that were compared to an age-sex-matched cohort of patients free of hyperprolactinaemia. The number of deaths and incident admissions with diabetes mellitus, cardiovascular disease, cancer, breast cancer, bone fractures and infectious conditions were compared by the survival analysis.Results: Patients with hyperprolactinaemia related to pituitary tumours had no increased risk of diabetes, cardiovascular disease, bone fractures, all-cause cancer or breast cancer. Whilst no increased mortality was observed in patients with pituitary microadenomas (HR = 1.65, 95% CI: 0.79-3.44), other subgroups including those with pituitary macroadenomas and drug-induced and idiopathic hyperprolactinaemia demonstrated an increased risk of death. Individuals with drug-induced hyperprolactinaemia also demonstrated increased risks of diabetes, cardiovascular disease, infectious disease and bone fracture. However, these increased risks were not associated with the degree of serum prolactin elevation (Ptrend > 0.3). No increased risk of cancer was observed in any subgroup.Conclusions: No excess morbidity was observed in patients with raised prolactin due to pituitary tumours. Although the increased morbidity and mortality associated with defined patient subgroups are unlikely to be directly related to the elevation in serum prolactin, hyperprolactinaemia might act as a biomarker for the presence of some increased disease risk in these patients.

KW - Hyperprolactinaemia

KW - Prolactin

KW - Pituitary gland

KW - Breast cancer

KW - Mortality

U2 - 10.1530/EC-17-0171

DO - 10.1530/EC-17-0171

M3 - Article

VL - 6

SP - 580

EP - 588

JO - Endocrine Connections

JF - Endocrine Connections

SN - 2049-3614

IS - 8

ER -