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The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome.
Eur J Clin Invest. 2018 Jul; 48(7):e12961.EJ

Abstract

BACKGROUND

To identify a serum prolactin (PRL) cut-off value indicative of a PRL-producing adenoma in women with polycystic ovarian syndrome (PCOS) and hyperprolactinaemia and characterize such patients.

MATERIALS AND METHODS

In the present retrospective case-control study, the medical records of 528 PCOS women were reviewed. Pituitary magnetic resonance imaging (MRI) was performed in PCOS patients with PRL levels ≥94.0 ng/mL and/or symptoms suspicious of a pituitary adenoma (PA). Prolactinoma diagnosis was made in the presence of an MRI-identifiable PA with biochemical and radiological response to dopamine agonists. Receiver operating characteristic (ROC) curve analysis was performed to determine a serum PRL threshold that could identify hyperprolactinaemic PCOS subjects with prolactinomas. Clinical, metabolic and endocrine parameters were also analysed.

RESULTS

Among 528 patients with PCOS, 60 (11.4%) had elevated PRL levels. Of 44 (73.3%) patients who had pituitary imaging, 19 had PAs, 18 normal MRI and 7 other abnormalities. Patients harbouring prolactinomas had significantly higher PRL levels compared to patients without adenomas (median PRL 95.4 vs 49.2 ng/mL, P < .0001). A PRL threshold of 85.2 ng/mL could distinguish patients with prolactinomas with 77% sensitivity and 100% specificity [Area Under the curve (AUC) (95%) 0.91(0.8-1.018), P = .0001]. PCOS women with prolactinomas were younger and had lower LH levels compared to women without prolactinomas.

CONCLUSIONS

In women with PCOS, PRL levels exceeding 85.2 ng/mL are highly suggestive of a prolactinoma warranting pituitary imaging. Pituitary MRI could also be considered in young PCOS patients with milder PRL elevation and low LH levels.

Authors+Show Affiliations

Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. Endocrine Unit, 2nd Department of Internal Medicine Propaedeutic, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, UK. Division of Endocrinology and Investigative Medicine, Imperial College London, London, UK.Department of Pathophysiology, National& Kapodistrian University of Athens, Athens, Greece.Department of Radiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.Department of Neurosurgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. Department of Pathophysiology, National& Kapodistrian University of Athens, Athens, Greece.Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, UK. Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29845629

Citation

Kyritsi, Eleni Magdalini, et al. "The Value of Prolactin in Predicting Prolactinοma in Hyperprolactinaemic Polycystic Ovarian Syndrome." European Journal of Clinical Investigation, vol. 48, no. 7, 2018, pp. e12961.
Kyritsi EM, Dimitriadis GK, Angelousi A, et al. The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome. Eur J Clin Invest. 2018;48(7):e12961.
Kyritsi, E. M., Dimitriadis, G. K., Angelousi, A., Mehta, H., Shad, A., Mytilinaiou, M., Kaltsas, G., & Randeva, H. S. (2018). The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome. European Journal of Clinical Investigation, 48(7), e12961. https://doi.org/10.1111/eci.12961
Kyritsi EM, et al. The Value of Prolactin in Predicting Prolactinοma in Hyperprolactinaemic Polycystic Ovarian Syndrome. Eur J Clin Invest. 2018;48(7):e12961. PubMed PMID: 29845629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome. AU - Kyritsi,Eleni Magdalini, AU - Dimitriadis,Georgios K, AU - Angelousi,Anna, AU - Mehta,Hiten, AU - Shad,Amjad, AU - Mytilinaiou,Maria, AU - Kaltsas,Gregory, AU - Randeva,Harpal S, Y1 - 2018/06/13/ PY - 2018/02/02/received PY - 2018/05/26/accepted PY - 2018/5/31/pubmed PY - 2018/11/16/medline PY - 2018/5/31/entrez KW - cut-off KW - hyperprolactinaemia KW - pituitary MRI KW - polycystic ovarian syndrome KW - prolactin KW - prolactinoma SP - e12961 EP - e12961 JF - European journal of clinical investigation JO - Eur. J. Clin. Invest. VL - 48 IS - 7 N2 - BACKGROUND: To identify a serum prolactin (PRL) cut-off value indicative of a PRL-producing adenoma in women with polycystic ovarian syndrome (PCOS) and hyperprolactinaemia and characterize such patients. MATERIALS AND METHODS: In the present retrospective case-control study, the medical records of 528 PCOS women were reviewed. Pituitary magnetic resonance imaging (MRI) was performed in PCOS patients with PRL levels ≥94.0 ng/mL and/or symptoms suspicious of a pituitary adenoma (PA). Prolactinoma diagnosis was made in the presence of an MRI-identifiable PA with biochemical and radiological response to dopamine agonists. Receiver operating characteristic (ROC) curve analysis was performed to determine a serum PRL threshold that could identify hyperprolactinaemic PCOS subjects with prolactinomas. Clinical, metabolic and endocrine parameters were also analysed. RESULTS: Among 528 patients with PCOS, 60 (11.4%) had elevated PRL levels. Of 44 (73.3%) patients who had pituitary imaging, 19 had PAs, 18 normal MRI and 7 other abnormalities. Patients harbouring prolactinomas had significantly higher PRL levels compared to patients without adenomas (median PRL 95.4 vs 49.2 ng/mL, P < .0001). A PRL threshold of 85.2 ng/mL could distinguish patients with prolactinomas with 77% sensitivity and 100% specificity [Area Under the curve (AUC) (95%) 0.91(0.8-1.018), P = .0001]. PCOS women with prolactinomas were younger and had lower LH levels compared to women without prolactinomas. CONCLUSIONS: In women with PCOS, PRL levels exceeding 85.2 ng/mL are highly suggestive of a prolactinoma warranting pituitary imaging. Pituitary MRI could also be considered in young PCOS patients with milder PRL elevation and low LH levels. SN - 1365-2362 UR - https://www.unboundmedicine.com/medline/citation/29845629/The_value_of_prolactin_in_predicting_prolactinοma_in_hyperprolactinaemic_polycystic_ovarian_syndrome_ L2 - https://doi.org/10.1111/eci.12961 DB - PRIME DP - Unbound Medicine ER -