Macroprolactinaemia modulates cardiometabolic effects of fenofibrate in men with atherogenic dyslipidaemia: A pilot study

• Published in: Journal of clinical pharmacy and therapeutics Vol. 45; no. 1; pp. 115 - 121
• Main Authors: Krysiak, Robert, Kowalcze, Karolina, Okopień, Bogusław
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.02.2020
• Subjects: 25-Hydroxyvitamin D; atherogenic dyslipidaemia; Blood pressure; cardiometabolic risk; Cholesterol; Dyslipidemia; Fenofibrate; fibrates; Fibrinogen; High density lipoprotein; Homeostasis; Homocysteine; Insulin; Lipids; Low density lipoprotein; macroprolactin; Metabolic disorders; Plasma levels; pleiotropic effects; Population studies; Prolactin; Triglycerides; Uric acid; fibrates; pleiotropic effects; cardiometabolic risk; atherogenic dyslipidaemia; macroprolactin
• ISSN: 0269-4727; 1365-2710; 1365-2710
• DOI: 10.1111/jcpt.13036

What is known and objective Cardiometabolic effects of hypolipidaemic agents depend on plasma levels of monomeric prolactin. Although macroprolactinaemia seems to be associated with increased cardiometabolic risk, no previous study has investigated whether macroprolactinaemia modulates pleiotropic effects of hypolipidaemic agents. Methods The study population included two age‐, weight‐, blood pressure‐ and lipid‐matched groups of men: 12 men with elevated levels of big‐big prolactin and 16 men with prolactin levels within the reference range. Because of atherogenic dyslipidaemia, all subjects were treated for 6 months with fenofibrate (200 mg daily). Glucose homeostasis markers and plasma lipids, as well as plasma levels of uric acid, high‐sensitivity C‐reactive protein (hsCRP), fibrinogen, homocysteine and 25‐hydroxyvitamin D, were determined in patients at the beginning and at the end of the study. Results and discussion Men with elevated levels of big‐big prolactin were characterized by higher levels of hsCRP and fibrinogen and lower levels of 25‐hydroxyvitamin D as well as decreased insulin sensitivity than subjects with prolactin levels within the reference range. In men without macroprolactinaemia, fenofibrate decreased circulating levels of total and LDL cholesterol, triglycerides, uric acid, hsCRP and fibrinogen, and increased concentrations of HDL cholesterol, homocysteine and 25‐hydroxyvitamin D, as well as improved insulin sensitivity. In subjects with macroprolactinaemia, fenofibrate action was limited to the changes in HDL cholesterol, triglycerides, hsCRP and homocysteine. With the exception of homocysteine, cardiometabolic effects of fenofibrate were stronger in subjects without than in subjects with elevated levels of big‐big prolactin. What is new and conclusion The results of the study indicate that macroprolactinaemia exerts a negative impact on cardiometabolic effects of fenofibrate.