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The value of PRL in predicting prolactinοma in hyperprolactinemic PCOS
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Kyritsi, Eleni Magdalini, Dimitriadis, Georgios K., Angelousi, Anna, Mehta, Hiten, Shad, Amjad, Mytilinaiou, Maria, Kaltsas, Gregory and Randeva, Harpal S. (2018) The value of PRL in predicting prolactinοma in hyperprolactinemic PCOS. European Journal of Clinical Investigation . e12961. doi:10.1111/eci.12961 (In Press)
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WRAP-value-PRL-predicting-prolactinoma-Randeva-2018.pdf - Accepted Version - Requires a PDF viewer. Download (1513Kb) | Preview |
Official URL: http://dx.doi.org/10.1111/eci.12961
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 hyperprolactinemia 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 hyperprolactinemic 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 harboring prolactinomas had significantly higher PRL levels compared to patients without adenomas (median PRL 95.4 vs. 49.2 ng/mL, p<0.0001). 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=0.0001]. 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.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Polycystic ovary syndrome -- Treatment, Hyperprolactinemia, Metabolism -- Disorders | ||||||
| Journal or Publication Title: | European Journal of Clinical Investigation | ||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||
| ISSN: | 1365-2362 | ||||||
| Official Date: | 29 May 2018 | ||||||
| Dates: |
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| Date of first compliant deposit: | 1 June 2018 | ||||||
| Article Number: | e12961 | ||||||
| DOI: | 10.1111/eci.12961 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | In Press | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| RIOXX Funder/Project Grant: |
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