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Maintenance of normal glucose metabolism during pregnancy is of particular importance. Prolactin may be a mediator in pathogenesis of impaired glucose metabolism. This study aimed to assess the levels of maternal serum prolactin in pregnant women with gestational Diabetes mellitus (GDM). This prospective observational study was done at AL– Emamain AL- Kadhemain Medical City/ Department of Obstetrics and Gynecology in Baghdad/ Iraq during the period from 1st March to 1st October 2018 on 150 pregnant women who were referred for OGTT for different indications. For all included women, maternal serum prolactin level and 75 gm OGTT was performed. The results showed that the mean±SD of maternal serum prolactin levels for all included women was (135.14±22.67) ng/ml and there was significantly negative correlation with (1hr) and (2hr) blood glucose levels of 75 gm OGTT at p value (0.027), (0.003) respectively. Out of 150 women included in the study (52) women diagnosed to have GDM and (98) women to have normal glucose tolerance. The mean±SD of maternal serum prolactin level was (123.6±13.7) ng/ml in GDM group which is significantly lower in comparison with mean ±SD (141.3±24.1) ng/ml in normal group at p value (0.0001). It can be concluded that women with GDM showed significantly lower serum prolactin levels in comparison with levels in women with normal glucose tolerance.

Background Dopamine agonists such as bromocriptine and cabergoline have been found to be an effective treatment for hyperprolactinemia, not only inducing adenoma shrinkage but also lowering serum prolactin levels. Among known dopamine agonists, cabergoline is the drug of choice due to its enhanced tolerability compared with bromocriptine. This study aimed to evaluate cabergoline's effectiveness, along with transsphenoidal surgery, in the treatment of hyperprolactinemia. Methods We retrieved all patients with a diagnosis of prolactinoma who were treated in our hospital during 2000-2018. A total of 208 patients were enrolled in the analysis after applying exclusion criteria. Patients were divided into four groups according to the treatments received. The demographic data, dosage and duration of cabergoline, and serum prolactin levels at different time points were collected for analysis. Results Normalization was achieved in 59 patients (83.10%) within a short median duration of 2.80 months among those treated with cabergoline only. Although cabergoline alone was effective and well-tolerated, our data showed that long-term remission rates were more favorable when surgery was involved. The long-term remission rate of all patients enrolled was 53.8% (112 patients among 208 patients). The long-term remission rates for the different treatment groups were 17.8% (8 of 45 patients) in Group 1 (Operation→Drug), 83.3% (5 of 6 patients) in Group 2 (Drug→Operation), 79.0% (68 of 86 patients) in Group 3 (Operation only), and 43.7% (31 of 71 patients) in Group 4 (Drug only). Conclusion Cabergoline has been demonstrated to be effective and should be considered as a first-line treatment for hyperprolactinemia. In our study, transsphenoidal surgery was also demonstrated to achieve good results compared with medical treatment. Surgical intervention may resurface as an alternative first-line treatment. When used in combination with cabergoline, surgery offers a higher disease remission rate than either drug or operation alone.

Risperidone and aripiprazole, commonly used antipsychotics in children with autism spectrum disorder (ASD), have previously been associated with elevated fracture risk in other populations. The aim of this study was to evaluate and compare the risk of fracture among children with ASD using risperidone or aripiprazole. This was a retrospective, propensity-score matched cohort study, set between January 2013 and December 2018. We used the MarketScan Medicaid insurance data, which covers multiple states of the United States. We included ASD children aged 2-18 years, who were new users of aripiprazole or risperidone and with no prior history of antipsychotic use or fractures. The main exposure was the continued use of aripiprazole or risperidone. The incidence rates of any fracture during follow-up were evaluated, and the risk between aripiprazole and risperidone was compared via Cox-proportional hazard models. Results were stratified by age, sex, duration of exposure and fracture site. In total, 3312 patients (78% male; mean [SD] age 11.0 [3.7] years) were identified for each cohort. Over the full duration of follow-up, fracture incidence rates per 1000 patient-years were 23.2 for risperidone and 38.4 for aripiprazole (hazard ratio and 95% confidence interval: 0.60 [0.44-0.83]). Risks were similar between cohorts throughout the first 180 days on treatment, but significantly higher in the aripiprazole group thereafter. Extremity fractures drove most of the increased risk, with the biggest differences in lower leg and ankle fractures. Differences widened for children aged 10 years or younger (HR [95% CI]: 0.47 [0.30-0.74]). In conclusion, compared to aripiprazole, risperidone was associated with 40% lower risk of fracture. Further analysis on the mechanism and long-term bone health of antipsychotic-treated children with ASD is warranted.Lay summary We compared the risk of bone fractures among 6624 children with autism spectrum disorder (ASD), half of whom used risperidone and half of whom used aripiprazole. Taking other factors into account, risks were similar between the two groups throughout the first 180 days on treatment, but significantly higher in the aripiprazole group thereafter. The biggest differences were in lower leg and ankle fractures. Overall, compared with aripiprazole, risperidone was associated with 40% lower risk of fracture.

Objective: Male infertility refers to a male’s inability to cause pregnancy in a fertile female. Infertility is a widespread problem for about one in five infertile couples. Male infertility is usually caused by a problem that affects either sperm production or sperm transport. The aim of the study was to evaluate prolactin levels in the serum and comparing the levels of fructose in the semen of infertile males and normal healthy controls of reproductive age of 20–45 years respectively. Methods: Hemoglobin (Hb) level in the blood of both groups was calculated by Sahli’s method using Sahli’s Hemoglobinometer. The Erythrocyte Sedimentation Rate (ESR) was determined using the modified Westergren’s method and total leukocyte count (TLC) in the blood was determined by microdilution method. Semen analysis was performed by the method specified in the World Health Organization Laboratory Manual. Morphology and motility of sperm and their counts were determined by microscopy. Fructose drop test in semen was estimated colorimetrically by the Semen Fructose Estimation Kit and determination of serum prolactin involved the use of Electrochemiluminescence immunoassay using Cobas e 411 analyzer. Results: Hb in infertile males was less than healthy controls. However, ESR in infertile men was considerably high and TLC, serum prolactin levels did not show much variation in infertile men. Seminal analysis of infertile men revealed high fructose levels and low sperm count with decreased motility. Conclusion: The concentration of seminal fructose in control group is lower than infertile males. High fructose levels in infertile men and less sperm count indicate oligozoospermia.

Background: To assess serum TSH and Prolactin in women with PCOS in comparison with healthy women as controls and to find correlation between TSH & Prolactin in PCOS subjects. Materials and Methods: A comparative study including 30 women diagnosed as PCOS and 30 age and BMI matched healthy women as controls was conducted. The age group for the study was 18-35 years. Fasting blood samples were drawn to measure serum thyroid stimulating hormone(TSH) and prolactin. Results: Mean TSH and prolactin were found elevated in the PCOS cases compared to controls but they were not statistically significant. No significant correlation was found between TSH and prolactin. Conclusion: We could not find any significant correlation between serum TSH and serum prolactin. Further, studies with larger number of PCOS subjects will be beneficial. However monitoring of Prolactin & TSH in PCOS should be done. Keywords: T3, T4, TSH, Depression.

espanolLa prolactina se secreta principalmente por las celulas lactotroficas adenohipofisarias. Como resultado, la hiperprolactinemia se produce casi exclusivamente por causas fisiologicas o patologicas que producen hipersecrecion de prolactina por dichas celulas. Las manifestaciones clinicas de la hiperprolactinemia son generalmente faciles de reconocer. En la mujer aparecen alteraciones del ciclo menstrual y galactorrea, mientras que en el varon se observara una disminucion de la libido y disfuncion erectil. El diagnostico de hiperprolactinemia se realiza mediante la demostracion de concentraciones de prolactina serica por encima del rango normal (> 20 ng/ml en hombres y mujeres posmenopausicas y > 25 ng/ml en mujeres premenopausicas). Una vez confirmada la hiperprolactinemia, el siguiente paso es determinar la causa. Tras descartar causas fisiologicas y farmacologicas, hay que realizar una evaluacion neurorradiologica de la region hipotalamica-hipofisaria, ya que un porcentaje elevado de hiperprolactinemias se deben a prolactinomas o enfermedades de la region hipotalamo-hipofisaria. EnglishProlactin hormone is mainly secreted by lactotroph cells of adenohypophyses. As consequence, the causes of hyperprolactinemia are almost exclusively physiological and pathological, triggering lactotroph cells prolactin hypersecretion. Clinically hyperprolactinemia is easily recognizable. In women symptoms are menstrual cycle disorders and galactorrhea; in men decreased libido and erectile dysfunction is observed. Diagnosis is performed by the measurement of serum prolactin levels above normal range (> 20 ng/ml in men and in post-menopausal women, and >25 ng/ml in pre-menopausal women). Once diagnosis is confirmed, cause has to be identified. Because in the most cases the etiology is prolactinoma or other disorder of the pituitary fossa (excluded physiologic or pharmacologic causes), neuro-imaging test of the hypothalamic-pituitary region has to be performed.

Objective:It is suggested that prolactin has a role in the pathogenesis of uterine adenomyosis. Besides, it is also reported that elevated cancer antigen 125 levels are related with this benign disorder. The aim of the study was to investigate serum prolactin and cancer antigen 125 levels in patients with adenomyosis.Methods:In this retrospective chart review study, data of patients with clinically diagnosed and histopathologically proven adenomyosis in hysterectomy specimens were analyzed. Patients were divided into two groups according to the ultrasonographically calculated preoperative uterine volume: Group 1 (n = 62): uterine volume ⩽240 cm3(⩽12 gestational weeks) and Group 2 (n = 42): uterine volume >240 cm3(>12 gestational weeks). Age, obstetric history, body mass index, preoperative hemoglobin, thyroid stimulating hormone, prolactin and cancer antigen 125 levels, and ultrasonographic findings were recorded. Preoperative prolactin and cancer antigen 125 values were compared between the two groups.Results:A total of 104 patients were included in the study. No differences in the baseline characteristics were observed between the groups, except the number of pregnancies and miscarriages. Furthermore, no significant differences were observed in terms of serum prolactin and cancer antigen 125 levels between the groups.Conclusion:Serum prolactin and cancer antigen 125 levels were not associated with uterine volume in patients with uterine adenomyosis.

Past investigations bring demonstrated the could be allowed part of prolactin in the improvement of RDS, Yet they didn't think about those maternal states which could impact the watched quality. We pointed with think about serum prolactin level Around sound preterm neonates Also preterm neonate for respiratory misery syndrome. Methods: those examine included 80 neonates (51 guys and 29 females). Those 1st one assembly (diseased): included 40 preterm babies for respiratory misery syndrome. Those second assembly (control): incorporated 40 solid preterm neonates. At baby subjected with research apgar score at 1 and 5 minutes. Serum Prolactin level might have been evaluated utilizing IRMA unit supplied Eventually Tom's perusing izotop Results: we watched helter skelter measurable noteworthy diminish from claiming serum prolactin level (ng/ml) Around preterm babies with RDS contrasted with the control aggregation for (P. Worth

Introduction: Prolactin is a hormone secreted from anterior pituitary gland which has different functions throughout the body of the fertile females. Women with polycystic ovary syndrome (PCOS) may exhibit a mild elevation of serum prolactin level. High prolactin level can affect the fertility potential causing ovulatory dysfunction. Even those with normal ovulation, failure of producing a sufficient amount of progesterone after ovulation may occur which resulted in a deficient endometrium; less liable for embryo implantation( luteal phase defect). Thus, this research is aimed to study the frequency of elevated prolactin in women with PCOS and to evaluate its' effect on pregnancy rate. Methods: Fifty-three infertile females were included. They divided in to two major groups: Group I: females with PCOS and Group II: females with no PCOS. Both groups sub-divided in to two subgroups: Group A with serum prolactin more than 20 ng/dl and Group B with normal serum prolactin 2-20 ng/dl. All females were included in ICSI program followed by assessment of pregnancy rate in both groups. Results: The study was showed that 69.44% of women who suffered from PCOS had an elevated serum prolactin level with a mean of 31.17±10.24. Pregnancy rate was lower in the females with high serum prolactin level in both PCOS and non-PCOS women. Conclusion: Hyperprolactinemia is more frequent in the females with PCOS than normal ovulatory females. Elevated serum prolactin level negatively affects implantation and decreases the chance of getting a pregnancy following ICSI.

Long-acting injectable (LAI) antipsychotics were developed to improve adherence to schizophrenia treatment. Paliperidone palmitate (PP) has two LAI forms: Monthly (PP1M) and three-monthly (PP3M). PP3M shows less difference in Peak-to-Trough drug concentration levels. This could be related to a lower incidence of hyperprolactinemia, which may negatively affect adherence. We aimed to compare prolactin levels and investigate relationships between prolactin levels, symptomatology and sexual function in patients with schizophrenia after switching from PP1M to PP3M.Twenty-five patients were enrolled. The sociodemographic data form, the Positive and Negative Syndromes Scale (PANSS) and the Arizona Sexual Experience Scale (ASEX) were used. Morning blood samples were drawn to determine prolactin levels.Prolactin level (p 0.001), the total score and arousal sub-score of ASEX (respectively; p = 0.015, p = 0.020) and the total score and positive scale of PANSS (respectively; p = 0.017, p = 0.021) were decreased on the 90th day (±15 days).After switching to PP3M, the decreases in prolactin levels and potentially related sexual side effects was statistically significant. There may be a difference between two formulations of the same drug in terms of side effects, and there is a need for prospective follow-up studies with larger samples.

Background: Infertility is a growing problem with adverse medical, social and psychological consequences globally. Apart from several causes of infertility, hormonal imbalance especially thyroid dysfunction and hyperprolactinemia can lead to female infertility. Both these conditions are treatable so Proper management of hormonal imbalance can result in restoration of normal fertility. Aims and objectives: Correlation of serum Prolactin and Thyroid hormone in female infertility. Materials and methods: Descriptive hospital based study was conducted at Nepalgunj medical college and teaching hospital, Nepalgunj, Banke, Nepal. The data was collected from September 2018 to August 2019. Total 30 cases of females of primary and secondary infertility attending outpatient department of gynecology department of Nepalgunj medical college were included in the study. A detailed history and clinical evaluation was done along with estimation of serum Prolactin and Thyroid hormone profile. Result: Hormonal status of subjects showed 15 i.e. 50% participants were thyroid whereas 11 (36.33%) were hypothyroid and 4 (13.33%) were hyperthyroid. Serum Prolactin was raised in 17 (57%) and normal in 13 (43%). Serum TSH and prolactin were found to be significantly positively correlated in female infertility (r=0.507, p =0.004). Conclusion: There is a high incidence of hyperprolactinaemia and thyroid dysfunction in female infertility.

Objective Antipsychotics may increase serum prolactin, which has particularly been observed with risperidone. Further, hyperprolactinemia has been linked to osteoporosis-related fractures. Therefore, we investigated fracture risk in a nationwide cohort exposed to antipsychotics. Methods Swedish registers were used to identify adults with two consecutive dispensations of risperidone (n = 38 211), other atypical antipsychotics not including paliperidone (n = 60 691), or typical antipsychotics (n = 17 445) within three months between 2006 and 2013. An osteoporosis-related fracture was defined as a non-open hip/femur fracture in primary analyses. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Risperidone users were on average older (mean age of 68, 44, and 63 years for risperidone, other atypical antipsychotics, and typical antipsychotics respectively). Compared with other atypical antipsychotics, there was no association between risperidone and osteoporosis-related fractures in the overall (HR = 1.04, CI: 0.91-1.19) or age-stratified analyses. A significantly increased risk of typical antipsychotics (HR = 1.24, CI: 1.07-1.45) compared with other atypical antipsychotics remained for ages >45 years. Conclusion Risperidone does not appear to be associated with an increased risk of osteoporosis-related fracture compared with other atypical antipsychotic agents as a group. For typical antipsychotics, a moderately elevated risk of hip fractures was noted compared with other atypical antipsychotics, possibly because of residual confounding.

Binding of 125I-labeled prolactin in the sera of women with different forms of hyperprolactinemia was studied. Antiprolactin autoantibodies were detected in the blood of 24% of women with idiopathic hyperprolactinemia. In contrast to idiopathic hyperprolactinemia, there were no autoantibodies to prolactin in pregnant women with physiological hyperprolactinemia and in hyperprolactinemia of tumor origin. These data indicate that the presence of these antibodies in circulating blood can be one cause of idiopathic hyperprolactinemia. Moreover, the prevalence of high-molecular form of immunoreactive prolactin in the blood can be due to binding of an appreciable amount of prolactin monomer to antiprolactin autoantibodies.

BACKGROUND We wanted to determine and compare the serum prolactin levels in lurasidone, and aripiprazole drug administered psychiatric patients. METHODS A hospital-based prospective observational study was done in the psychiatric department, RIMS, Kadapa for a period of 06 months (i.e., from Sept. 2018 to Feb. 2019). Patients receiving drugs (Lurasidone/Aripiprazole) were enrolled in our study. Patients in the age group 20-60 years were recruited. Consecutive sampling method was followed during the study procedure. 300 patients were recruited according to study criteria. Ethical approval was obtained from IEC. After taking the informed consent from the patient, data collection form was designed accordingly and given to patients to collect patients’ complete data. Collected data was analysed and interpreted by using the SPSS/Graph Pad Prism/Chi-Square Test. RESULTS We have recruited 300 patients with 150 patients in each group. We have analysed the blood samples of the patients for serum prolactin levels. We have reviewed the patients three times and we have found the mean and standard deviation of each drug in every review. We have analysed the serum prolactin levels based on gender and age differences. And we have compared the other ADR's of the two drugs based on gender differences. And we have also compared the serum prolactin levels of each drug from their base line to third review. CONCLUSIONS From the data collected after each review, it can be concluded that Aripiprazole is a safe drug compared to lurasidone. After assessing the serum prolactin levels, we noted that lurasidone increased prolactin levels dramatically in females and adult patients with age between 25 to 38.5 years. After the collection of statistical data, it can be concluded that Aripiprazole is the safer antipsychotic drug.

Background: Polycystic ovarian syndrome has been one of a major public health problem in India that leads to medical consequences. It causes multifactorial in etiology such as menstrual dysfunction, hyperandrogenism, hirsutism, insulin resistance, dyslipidemia and obesity which increased risk of diabetes mellitus and cardiovascular disease. Prolactin has been reported as a potent lipogenic and diabetogenic factor, that affecting energy balance and fuel metabolism. The present study was designed to assess serum prolactin and insulin resistance in PCOS women and to compare them with healthy women as controls. Material and Methods: A comparative study including 50 women diagnosed as PCOS and 50 age and BMI matched healthy women as controls was conducted. The age group for the study was 18-35 years. Body Mass Index was calculated as a physical parameter. Fasting blood samples were drawn to assess serum prolactin, serum insulin, HbA1c and fasting blood sugar. Insulin resistance was calculated by homeostasis model assessment. Results: A significant increase in fasting serum insulin (p Conclusions: The current study provides further evidence that significantly higher fasting insulin and HOMA in PCOS group indicates presence of IR. IR in PCOS group may have a potential role in the prediction of dysglycemic disease in women with PCOS. This study could not find any significant correlation between serum prolactin, serum insulin and BMI.

Fuyin Yang,1–4 Lan Chen,5 Xinyu Fang,6 Ke Zheng,1 Cheng Zhu,1 Chaoqun Xu,1 Chen Zhang,6 Wei Tang11Wenzhou Kangning Hospital, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; 2Faculty of Arts and Science, New York University Shanghai, Shanghai, China; 3Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China; 4NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China; 5School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; 6Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200232, ChinaObjectives: It has been well documented that elevation of serum prolactin (PRL) level and weight gain are common in patients receiving treatment with atypical antipsychotics. The existing evidences show that serum PRL is elevated in schizophrenic patients treated with olanzapine. However, little is known about the long-term effects of olanzapine on PRL levels and weight gain in female patients with schizophrenia. Materials and methods: This study addressed this issue by investigating the relationship between serum PRL level and body mass index (BMI). Seventy-nine female patients with first-episode schizophrenia were recruited and received olanzapine monotherapy for 12 weeks. Serum PRL level and BMI were measured at baseline and at 4, 8, 12 weeks. Thirty-five age-matched healthy female individuals were recruited as controls. The severity of psychiatric symptoms was evaluated using the Positive and Negative Syndrome Scale. Results: The olanzapine treatment for 12 weeks significantly increased serum PRL (P

IntroductionUterine leiomyomas (UL) are highly prevalent benign smooth muscle tumors, seen in approximately 70% of women. These hormone re- sponsive tumors are also known to secrete prolactin (PRL), a hormone of the anterior pituitary gland. Elevated levels of serum prolactin are a com- mon clinical finding in different gynecological pathologies including UL. However, the underlying causes for this elevation are not yet clear. Therefore, the main objective of this study is to measure the serum PRL in UL patients and also to investigate its molecular connection with coding region somatic mutations of the PRL gene.Material and methodsThe serum PRL levels of UL patients were measured through the ELISA method. The coding region PRL gene mutations in UL and corresponding myometrium tissues were screened through the Sanger sequencing method.ResultsUterine leiomyoma patients demonstrated significant elevation of the PRL hormone level in serum samples (p ≤ 0.01). No somatic coding re- gion mutations in the PRL gene were identified. However, four germline vari- ants (c.570G>A, c.205-102T>A, c.312+177T>C and c.269C>T) were detected.ConclusionsThis study is the first one to confirm that serum PRL level ele- vation among UL patients is not connected to somatic mutations in the PRL gene. However, PRL genetic polymorphisms may indirectly contribute to the disease etiology.

Macroprolactinemia frequently causes misdiagnosis, unnecessary investigation and inappropriate treatment in hyperprolactinemic patients. Aim of this study is to investigate the prevalence and clinical characteristics of Thai patients with macroprolactinemia. We performed a cross-sectional study in 56 hyperprolactinemic patients (51 women and 5 men) whose sera were subsequently tested for the presence of macroprolactin. Recovery of less than 40% of serum prolactin after polyethylene glycol (PEG) precipitation was indicative of macroprolactinemia. Our study revealed 19.64% (11/56) of patients with hyperprolactinemia were found to have a preponderance of macroprolactin. All patients with macroprolactinemia were women, of which eight of them were initially diagnosed as idiopathic hyperprolactinemia and mistreated with dopamine agonist medications. Interestingly, neuroradiological abnormalities were reported in three patients with macroprolactinemia, 2 cases with prolactinoma and one case with stalk effect hyperprolactinemia. In conclusion, nearly one-fifth of our patients with hyperprolactinemia have macroprolactinemia. This finding suggests that the diagnostic algorithm of all patients with hyperprolactinemia should include the PEG precipitation test as the initial step. Domain: Endocrinology.

Backgrounds To investigate the value of prolactin (PRL) in diagnosing non-alcoholic fatty liver disease (NAFLD). Methods Metabolic parameters and serum PRL levels were measured in 452 males and 421 females, who were randomized to the estimation or the validation group as a 1:1 ratio. Hepatic steatosis was diagnosed via abdominal ultrasound. Variables that significantly associated with NAFLD in univariate analysis were included in multiple logistic regression. We used the receiver operator characteristic (ROC) curves to test the model performance. Besides, 147 patients underwent metabolic and liver biopsy were analyzed to validate the diagnostic value of this model. Results Body mass index, alanine aminotransferase, prolactin, high density lipoprotein cholesterol and HbA1c were included into models. In males, the area under ROC curve (AUC) was 0.86 (95%CI: 0.82–0.91) for the validation group. With two cut-off points (− 0.79 and 1.71), the sensitivity and specificity for predicting NALFD was 95.2 and 91.1% in the validation group, respectively. In females, the AUC was 0.82 (95%CI: 0.76–0.88) for the validation group. With two cut-off points (− 0.68 and 2.16), the sensitivity and specificity for predicting NALFD was 97.1 and 91.4% in the validation group, respectively. In subjects with liver pathology, the AUC was higher than that of fatty liver index. A positive correlation between the scores of the model and the severities of NAFLD was observed. Importantly, we demonstrated a potential value of this model in predicting nonalcoholic steatohepatitis. Conclusion We established a mathematic model that can conveniently and effectively diagnose the existence and severities of NAFLD.

Objectives: This study assessed the association between serum prolactin (PRL) concentration and aggression in female patients with schizophrenia. Methods: Female patients with schizophrenia (N = 120) were diagnosed using SCID-5 based on the DSM-5 criteria. They were sampled at the University Psychiatric Hospital Vrapce during the period from March 2017 to March 2019. Aggression was evaluated using the Positive and Negative Syndrome Scale (PANSS), and Overt Aggression Scale (OAS). Patients were subdivided into aggressive and non-aggressive groups. PRL was determined in serum using electrochemiluminescence (ECLIA) method. Results: Aggressive patients with schizophrenia had significantly (p < 0.0001) increased PRL concentration compared to non-aggressive patients. Higher PRL concentration was significantly (p < 0.0001) associated with pronounced aggressive symptoms determined by the OAS scores. When patients were subdivided into those who were treated with risperidone, haloperidol, paliperidone, amisulpride, and a group that was not treated with these antipsychotics, aggressive patients in both groups had significantly higher PRL concentrations than non-aggressive patients. Higher antipsychotic dose was related to increased PRL concentration (p = 0.004). Conclusions: Our findings suggest that higher PRL is significantly associated with aggression, irrespective of the antipsychotic medication, in female patients with schizophrenia.

Background:Reference intervals (RIs) play key roles in clinical diagnosis, treatment and prognosis. However, RIs for clinical testing tend to be confined to the general population, and RIs for pregnant women are not very comprehensive. In this study, we establish RIs for prolactin (PRL) in healthy pregnant and postpartum women in the Chinese population.Methods:Healthy pregnant women (n=378) were divided into groups according to whether they were in the first, second or third trimester of pregnancy. Healthy postpartum women (n=493) were separated into four groups according to mode of delivery as follows: postvaginal (24 and 48 h) or postcesarean (24 and 48 h). Healthy, non-pregnant women (n=123) were enrolled as a control group. Serum PRL levels were measured by electrochemiluminescence immunoassay, and RIs were established for each group.Results:The RIs for PRL were as follows: healthy non-pregnant women, 178.89–757.52 μIU/mL; first trimester, 621.20–3584.00 μIU/mL; second trimester, 1432.00–5349.68 μIU/mL; third trimester, 4087.33–9733.65 μIU/mL; 24 and 48 h postvaginal delivery (combined), 7865.36–10998.86 μIU/mL; and 24 and 48 h postcesarean delivery, 4556.41–7675.99 and 6578.45–9980.45 μIU/mL, respectively.Conclusions:PRL RIs for pregnant women were established according to trimester, days postpartum and mode of delivery, thus providing a clinical reference for medical staff.

INTRODUCTION Prolactinomas are common pituitary adenomas managed medically or surgically. METHODS Reviewed 181 prolactinomas resected transsphenoidally 2012-2019. Tumor volumes were quantified using BrainLab Smartbrush. Pearson correlation analysis and linear regression were used to identify associations between tumor volumes and serum prolactin. Tumor density was defined as serum prolactin divided by tumor volume. RESULTS Mean tumor volume was 6.33cm3 and mean pre-op prolactin was 803.4ug/L, with men having larger (12.11 vs 2.93cm3;p< 0.001) and women having denser (173.9 vs 107.6ug/L/cm3;p=0.011) prolactinomas. Pearson correlation (R=0.688;p< 0.001) and linear regression revealed a strong association between pre-op volume and prolactin levels, with 96.9g/L increase in prolactin/cm3 increase in volume (p< 0.001); this holds true for men (R=0.584;p< 0.001) and women (R=0.939;p< 0.001), with women demonstrating greater prolactin/cm3 tumor density (186.5 vs 75.0ug/L;p< 0.001). MiB index did not correlate with pre-op volume (p=0.449) or pre-op prolactin (p=0.452). Logistic regression showed decreased biochemical remission with increasing pre-op volume (OR=0.891;p< 0.001). Increased MiB index (p=0.971) and p53 (p=0.525) staining did not affect remission rates. Positive PIT-1 staining was associated with higher remission rates (OR=2.508;p=0.005). Patients without remission had denser tumors (149.9 vs. 100.6ug/L/cm3;p=0.013), with Pearson correlation yielding R=0.736 between pre-op volume and pre-op prolactin (p< 0.001), and R=0.476 between residual volume and post-op prolactin (p< 0.001). Patients without remission exhibited 142.9ug/L increase in prolactin/cm3 of pre-op volume (p< 0.001), higher than the 58.9ug/L increase in prolactin/cm3 in patients with remission (p< 0.001). Patients without remission had residual tumors with 68.4ug/L increase in prolactin/cm3 of remaining volume after resection (p< 0.001). CONCLUSION Our analysis revealed significant correlation between prolactinoma volume and serum prolactin levels. Patients without remission had greater tumor cellular density than those with remission. The volume-prolactin correlation persisted post-operatively, although surgery reduced tumor density. These results could identify prolactinomas for which surgery could achieve biochemical remission.

Background and aims: Diabetes is one of the causes of end-stage renal disease, so that about 70% of all diabetic patients have nephropathy. Prolactin is a hormone that is affected by diabetes but the interaction between diabetes and prolactin has not been understood properly. This study aimed to evaluate the relationship between changes in serum prolactin levels in diabetic patients with renal failure. Material and methods: In this study 223 individuals were participated and after assessment of inclusion/exclusion criteria 189 individuals were evaluated. Finally, the individuals were divided into three groups: Control (C), Diabetic (D), and Diabetic Nephropathy (DN). Blood samples were collected between 8.00 a.m. and 12.00 a.m. for measurement of prolactin levels and biochemical analysis. Results: The results showed that sodium, potassium, urea, creatinine and prolactin significantly increased in DN group compared to control individuals (P< 0.001). The prolactin levels were significantly decreased in the group of patients with diabetes (P< 0.001). Conclusion: The results of the current study indicated that serum prolactin level decreased in diabetes while it increased in diabetic nephropathy.

Prolactinomas are the most common functional pituitary tumour. Dopamine agonists (DA) are its principal treatment. The criteria that should guide therapy withdrawal and the factors that influence disease remission or relapse are not yet fully established. Our purpose is to evaluate the proportion of patients who attempted DA withdrawal, and to identify the factors that influence clinicians to try it. In addition, we aim to study the factors that are involved in prolactinoma remission/relapse after therapy withdrawal. We retrospectively evaluated 142 patients with prolactinoma diagnosis who had been treated exclusively with DA. Firstly, the patients were divided in two groups, according to whether DA withdrawal had been attempted, or not, and the factors that might predict clinicians’ decision to discontinue the therapy were then analysed. Secondly, patients who attempted withdrawal were further divided into two subgroups, based on their remission or relapse status and predictors of remission were evaluated. DA withdrawal was attempted in 35.2% of our patients. Females, subjects with lower initial serum prolactin (PRL) levels, those with microadenomas and those with longer treatment duration all had a higher probability of seeing their therapy discontinued. In the withdrawal group, the remission rate was 72%. Macroprolactinomas relapse more often than microprolactinomas (p

SummaryMedications prescribed by psychiatrists are known to elevate serum prolactin levels, but hyperprolactinaemia remains underrecognised, as the adverse effects of an elevated prolactin are mostly not visible. Hyperprolactinaemia can lead to adverse health outcomes, so clinicians need not only to be alert to its symptoms, but to manage the consequences as well. In this article we provide a brief overview of prolactin physiology, regulation and function. We list various factors that can lead to elevated serum prolactin. We discuss the interpretation of blood results and the management of psychotropic-induced hyperprolactinaemia. We include a flow diagram to assist clinicians in decision-making in the clinical management of hyperprolactinaemia.Learning Objectives• Understand prolactin physiology and regulation• Understand hyperprolactinaemia and its causes• Know the consequences of hyperprolactinaemia and appropriately manage it in clinical practice

Objective This study aimed to evaluate the relationship between circulating prolactin level and systemic lupus erythematosus (SLE), and to establish a correlation between plasma/serum prolactin levels and SLE activity. Methods We performed a meta-analysis comparing the plasma/serum prolactin levels in patients with SLE to controls, and examined correlation coefficients between circulating prolactin level and SLE disease activity. Results Twenty-five studies with a total of 1056 SLE patients and 426 controls were included. Prolactin levels were significantly higher overall in the SLE group than in the control group (standardized mean difference (SMD) = 0.987, 95% CI = 0.512–1.463, p = 4.7 × 10−5). Stratification by ethnicity showed significantly elevated prolactin levels in the SLE group in Asian, Latin American, and mixed populations (SMD = 0.813, 95% CI = 0.137–1.490, p = 0.018; SMD = 0.981, 95% CI = 0.307–1.655, p = 0.004; SMD = 1.469, 95% CI = 0.443–2.495, p = 0.005, respectively), but not in the European population. Subgroup analysis by sample size showed significantly higher prolactin levels in the SLE group by small ( n 30). Meta-analysis of correlation coefficients showed a significantly positive correlation between circulating prolactin level and SLE activity (correlation coefficient = 0.379, 95% CI = 0.026–0.487, p = 4.0 × 10−9). Circulating prolactin levels were positively associated with SLE activity in European, Asian, and mixed populations (SMD = 0.532, 95% CI = 0.443–0.609 p −8; SMD = 0.427, 95% CI = 0.240–0.583, p = 2.4 × 10−5; SMD = 0.433, 95% CI = 0.212–0.591, p = 2.7 × 10−5, respectively). Conclusions Our meta-analysis demonstrated that circulating prolactin levels are higher in patients with SLE, and that a significantly positive correlation exists between prolactin levels and SLE activity.

Aim Aripiprazole (ARP) is a popular antipsychotic drug that has demonstrated ameliorative effects on hyperprolactinemia. However, no study to date has studied the utility of ARP in patients with a long history of schizophrenia and antipsychotic treatment. We therefore examined the effect of partial antipsychotic regimen replacement with ARP on hyperprolactinemia induced by chronic antipsychotic use in patients with schizophrenia. Methods Sixteen patients with a schizophrenia diagnosis (F2) based on the International Classification of Diseases (version 10) were recruited. At months 0, 1, 3, and 6 of the study, serum prolactin, body weight, and blood glucose were measured, and QOL and psychotic symptoms were assessed using Global Assessment of Functioning scores and Clinical Global Impressions of Improvement (CGI-I) scores. Results Nine patients with an average age of 46.7 ± 9.6 years and mean disease duration of 15.9 ± 10.4 years were included in the final analysis. Serum prolactin levels significantly decreased and GAF and CGI-I scores improved significantly over the 6-month period after partial replacement with ARP. Additionally, no changes were observed in body weight or blood glucose over the 6-month period. Conclusion Partial antipsychotic regimen replacement with ARP improves hyperprolactinemia, and may improve the QOL of patients with a long history of schizophrenia. Clinical trial registration number Japan Medical Association, Center for clinical trials D: JMA-IIA00245.

Background Central hemodynamics and especially wave reflection amplification exhibit a vital parameter of chronic heart failure (CHF) physiology. Erectile dysfunction (ED) displays a poor peripheral vessel rheology and serum prolactin role is still debated in CHF mechanisms. The Mediterranean diet (Med-diet) is famous for its vasoprotective and wellbeing properties. Purpose To investigate the effect of the Med-diet in central hemodynamics, erectile status, atheroma formation and serum prolactin levels in male patients with chronic heart failure. Methods 123 CHF male patients under optimal medical therapy enrolled the study (mean age: 65±8 yo, NYHA class II, ejection fraction Results The SHIM −5 score (mean: 12±4) was associated to the AIx (p=0,03, r=0,75) and both positively and strongly related to the Med-diet score (p=0,01, r=0,8 and p=0,01, r=0,75 respectively). Med-diet compliance was negatively associated to IMT (p=0,02, r=−0,8) and serum prolactin levels (p=0,03, r=−0,6).Moreover, we notice a positive association between prolactin and the IMT (p=0,04, r=0,7). By multiple linear regression analysis the relation of SHIM-5 and Med-diet score remained significant (p=0,04) after adjustment for BMI, central pulse and mean arterial pressures. We further subdivide our population according to the mean Med-diet value (28) into high and low Med-diet adherence groups. Only in the group with the greater Med-diet adherence (n=73, 60%) AIx was strongly associated to the SHIM-5 score (p=0,02) even after adjustment for PWV, age and BMI. Prolactin levels there were still related to IMT (p=0,04) after adjustment for PWV, AIx, BMI and central pulse pressure. All statistics remained significant when adjusting for ejection fraction of the left ventricle. Conclusion High adherence to the Med-diet benefits CHF hemodynamics by enforcing wave reflection amplification, thus generating a stronger pulse signal to peripheral vasculature. Moreover suppresses serum prolactin levels that relates to atheroma formation. Both actions enhance erectile performance independently of the EF of the left ventricle. It is important to advise CHF patients to adopt this dietary pattern in order to improve hemodynamic status and the sense of wellbeing.

Objective To demonstrate how effectively aripiprazole can be utilized to manage antipsychotic-induced hyperprolactinemia. Methods The files of 3 female patients with a history of psychotic illness and hyperprolactinemia who were treated at a state hospital between February 2018 and May 2019 were retrospectively analyzed. All were found to have elevated prolactin levels and underwent treatment with aripiprazole in addition to their concomitant medications. Results In general, the addition of aripiprazole to the treatment regimen of each of the patients corresponded to a decline in their serum prolactin levels. Conclusions Hyperprolactinemia is frequently observed in patients treated with antipsychotic medications. Low-dose treatment with aripiprazole may offer a relatively rapid relief from sustained hyperprolactinemia and associated adverse effects even after a long-acting injectable is discontinued.

Hyperprolactinemia is a common endocrine disorder of hypothalamic-pituitary axis. It affect about 4-17% of women in reproductive age and about 3-10% of patients with polycystic ovaries. Vitamin B6 is an effective prolactin inhibitor that is extremely cheap and safe.it exerts hypothalamic dopaminergic effect which causes a significant reduction in prolactin level. The aim of the study is To evaluate the effectiveness of vitamin B6 in reducing serum prolactin in Hyperprolactinemic patient. Compare this effect to that of cabergoline.

Summary Background Falsely elevated prolactin measurements risk overdiagnosis, and unnecessary imaging and treatment. Design We conducted a clinical audit of 18 patients who presented with hyperprolactinaemia, followed by a laboratory audit of 40 split samples across a range of serum prolactin (5‐5051 mIU/L). In each case (total n = 58), serum prolactin was measured on both Roche and Siemens platforms. Results Serum prolactin as measured by Roche was higher than the corresponding Siemens value in every case, despite similar reference ranges. The mean discrepancy in serum prolactin by Roche vs. Siemens was +81% in the clinical audit and +50% in the laboratory audit. This led to unnecessary interventions in 7/18 patients (39%) in the clinical audit. Conclusions Serum prolactin is overestimated on the Roche relative to the Siemens platform. Laboratories should review Roche reference intervals for serum prolactin, and clinicians should consider repeating serum prolactin on another platform if the serum prolactin is incongruent with the clinical scenario.

OBJECTIVEProlactinoma and nonfunctioning adenoma (NFA) are the most common sellar pathologies, and both can present with hyperprolactinemia. There are no definitive studies analyzing the relationship between the sizes of prolactinomas and NFAs and the serum prolactin level. Current guidelines for serum prolactin level cutoffs to distinguish between pathologies are suboptimal because they fail to consider the adenoma volume. In this study, the authors attempted to describe the relationship between serum prolactin level and prolactinoma volume. They also examined the predictive value that can be gained by considering tumor volume in differentiating prolactinoma from NFA and provide cutoff values based on a large sample of patients.METHODSA retrospective analysis of consecutive patients with prolactinomas (n = 76) and NFAs (n = 217) was performed. Patients were divided into groups based on adenoma volume, and the two pathologies were compared.RESULTSA strong correlation was found between prolactinoma volume and serum prolactin level (r = 0.831, p < 0.001). However, there was no significant correlation between NFA volume and serum prolactin level (r = −0.020, p = 0.773). Receiver operating characteristic curve analysis of three different adenoma volume groups was performed and resulted in different serum prolactin level cutoffs for each group. For group 1 (≤ 0.5 cm3), the most accurate cutoff was 43.65 μg/L (area under the curve [AUC] = 0.951); for group 2 (> 0.5 to 4 cm3), 60.05 μg/L (AUC = 0.949); and for group 3 (> 4 cm3), 248.15 μg/L (AUC = 1.0).CONCLUSIONSProlactinoma volume has a significant impact on serum prolactin level, whereas NFA volume does not. This finding indicates that the amount of prolactin-producing tissue is a more important factor regarding serum prolactin level than absolute adenoma volume. Hence, volume should be a determining factor to distinguish between prolactinoma and NFA prior to surgery. Current serum prolactin threshold level guidelines are suboptimal and cannot be generalized across all adenoma volumes.

Based on the recent evidence of association between hyperprolactinemia and systemic lupus erythematosus disease activity (SLEDAI), a study was conducted to analyze the association of hyperprolactinemia with lupus nephritis disease activity. In this cross-sectional study, the analysis was conducted on SLE patients who visited the University Kebangsaan Malaysia Medical Centre (UKMMC) Nephrology Clinic from August 2015 till February 2016. The disease activity was measured using the SLEDAI score, with more than 4 indicating active lupus nephritis. Basal resting prolactin level was analyzed in 43 patients with lupus nephritis, in 27.9% of them had raised serum prolactin. The median of serum prolactin level at 0 minutes was 19.91 ng/mL (IQR: 15.95-22.65 ng/ mL) for active lupus nephritis, which was significantly higher compared to the median of serum prolactin level of 14.34 ng/mL (IQR: 11.09-18.70 ng/mL) for patients in remission (p=0.014). The serum prolactin level positively correlated with SLEDAI (rhos: 0.449, p=0.003) and the UPCI level in lupus nephritis patients (rhos: 0.241, p=0.032). The results were reproduced when the serum prolactin was repeated after 30 minutes. However, the serum prolactin levels at 0 minutes were higher than those taken after 30 minutes (p=0.001). An assessment of serum IL-6 levels found that the active lupus nephritis patients had a higher median level of 65.91 pg/ mL (IQR: 21.96-146.14 pg/mL) compared to the in-remission level of 15.84 pg/mL (IQR: 8.38-92.84 pg/mL), (p=0.039). Further correlation analysis revealed that there was no statistical correlation between the interleukin (IL)-6 levels with serum prolactin, SLEDAI and other lupus nephritis parameters. An ROC curve analysis of serum prolactin at 0 minutes and serum prolactin after 30 minutes and IL-6 levels for prediction of SLE disease activity provided the cutoff value of serum prolactin at 0 minutes, which was 14.63 ng/mL with a sensitivity of 91.7% and specificity of 58.1% and AUC of 0.74 (p=0.015). This study concurred with the previous findings that stated that hyperprolactinemia is prevalent in SLE patients and correlated with clinical disease activity and UPCI level. The baseline of the fasting serum prolactin level was found to be a sensitive biomarker for the evaluation of lupus nephritis disease activity.

The current study aimed to investigate whether peripheral modulators of serotoninergic function and neurohumoral factors’ changes in athletic horses during an official jumping competition, and to evaluate their relationship with the physical performance of competing horses. From 7 Italian Saddle mares (6–9 years, mean body weight 440 ± 15 kg), performing the same standardized warm-up and jumping course during an official class, heart rate (HR) was monitored throughout the competition. Rectal temperature (RT) measurement, blood lactate and glucose concentration, serum tryptophan, leucine, valine, the tryptophan/branched-chain amino-acids ratio (Try/BCAAs), dopamine, prolactin, and non-esterified fatty acids (NEFAs) were assessed before the exercise event (T0), at the end of the competition stage (5 min ± 10 sec following the cessation of the exercise, TPOST5), and 30 min after the end of competition (TPOST30). Highest HR values were recorded during the course and at the outbound (p &lt, 0.0001), blood lactate concentration and RT increased after exercise with respect to the rest condition (p &lt, 0.0001). Lower leucine and valine levels (p &lt, 0.01), and higher tryptophan, Try/BCAAs ratio, and NEFAs values were found at TPOST5 and TPOST30 with respect to T0 (p &lt, 0.0001). A higher prolactin concentration was found atTPOST5 and TPOST30 compared to T0 (p &lt, 0.0001), whereas dopamine showed decreased values after exercise compared to rest (p &lt, 0.0001). Statistically significant correlations among the peripheral indices of serotoninergic function, neurohumoral factors, and athletic performance parameters were found throughout the monitoring period. The findings provide indirect evidence that the serotoninergic system may be involved in fatigue during jumper exercise under a stressful situation, such as competition, in which, in addition to physical effort, athletic horses exhibit more passive behavior.

Objetives. To determine the correlation between prolactin levels and disease activity classified based on the Mexican lupus erythematosus disease systemic activity index (MEX SLEDAI).Methods. In this cross-sectional observational study, serum prolactin, age, sex, treatment, as well as manifestations of active disease were determined. Disease activity was evaluated using the Mexican Systemic Lupus Erythematosus Activity Index (MEX-SLEDAI). The correlation of MEX-SLEDAI with prolactin was determined using the Spearman correlation coefficient. The significance of differences between continuous variables was determined with the non-paired Student’s t test and the significance of differences between categorical variables was determined with Chi-square test.Results. 55 patients were included, 10 (18.1%) had MEX-SLEDAI ≥ 7 and 45 (81.8%) less than 7. A positive correlation was found with a Spearman rho 0.387 (p = 0.004) between the MEX-SLEDAI and the levels serum prolactin. Subjects with active disease and hyperprolactinemia had 80% manifestations at the renal level (p = 0.001).Conclusion. There is significant correlation between prolactin levels and disease activity. Hyperprolactinemia were detected in patients with renal activity as well as those with MEX-SLEDAI ≥ 7.

Theeffect of crude methanol extract (CME) and fractions (n-hexane, ethyl acetate, n-butanol and water) of Stachytarphetajamaicensis (SJ) leaves were evaluated on serum prolactin (PRL) secretionin albino rats. Female rats that received oral doses (200, 400 or 800 mg/kg) of CME during their first lactation showed a dose-dependent significant increase (P BF > HF > WF (800 mg/kg) respectively. The estrogen-primed treated rats produced a high serum PRL concentration compared to the non-primed rats.In addition, mammary gland of estrogen-primed rats treated with the CME and fractions showedclear lobulo-alveolar development with milk secretion. The acute toxicity test of CME and fractions of SJ indicated that the plant is safe as the LD50 was found to be above 5000 mg/kg. This study demonstrates that SJ leaves can stimulate PRL secretion in the female rats which supports its traditional usage in lactating women.

Given that both prolactin and galanin take part in the regulation of energy homeostasis and that galanin is localized within lactotrophs, this study was aimed at comparing the pituitary expression patterns of prolactin and galanin during different phases of metabolic response to starvation in adult Wistar male rats. Food was removed at the onset of the dark phase (6:00 pm) and the animals were deprived for 6, 12, 24 and 48 h. Each of the starved groups (n=6) was killed simultaneously with a group of ad libitum-fed rats (n=6), and the intrapituitary levels of prolactin and galanin were examined. Galanin expression in the hypothalamus and the circulating levels of prolactin were also assessed. Starvation induced a rise in the intrapituitary prolactin level (p

There is increasing evidence associating idiopathic granulomatous mastitis (IGM) with hyperprolactinemia. All documented cases have involved the patient having at least one operative procedure before the association has been made. We present a 55 year old female with IGM associated with risperidone induced hyperprolactinemia. She was successfully treated with a dopamine agonist, bromocriptine. We demonstrated that complete resolution can be achieved without surgical intervention, by targeting serum prolactin levels. We hope this will increase awareness of this rare clinically entity and avoid potentially unnecessary surgery.