The epidemiology of hyperprolactinaemia over 20 years in the Tayside region of Scotland: the Prolactin Epidemiology, Audit and Research Study (PROLEARS)

• Published in: Clinical endocrinology (Oxford) Vol. 86; no. 1; pp. 60 - 67
• Main Authors: Soto‐Pedre, Enrique, Newey, Paul J., Bevan, John S., Greig, Neil, Leese, Graham P.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.01.2017
• Subjects: Adult; Female; Humans; Hyperprolactinemia - chemically induced; Hyperprolactinemia - epidemiology; Incidence; Male; Middle Aged; Prevalence; Retrospective Studies; Scotland - epidemiology; Young Adult
• ISSN: 0300-0664; 1365-2265; 1365-2265
• DOI: 10.1111/cen.13156

Summary Objective To estimate the prevalence and incidence of hyperprolactinaemia. Hyperprolactinaemia is a common problem in endocrine practice, but its epidemiology has not been accurately established. Study design A population‐based retrospective follow‐up study in Tayside, Scotland (population 400,000), from 1993 to 2013. Patients Record linkage technology (biochemistry, prescribing, hospital admissions, radiology, mortality and maternity data) was used to identify all patients with a serum prolactin measurement. From these, cases were defined as those with a prolactin greater than 1000 mU/L (47·2 ng/ml) or at least three prescriptions for a dopamine agonist. Measurements Number of prevalent and incident cases of hyperprolactinaemia per calendar year by age, sex and cause of hyperprolactinaemia. Results A total of 32289 patients had a serum prolactin assay undertaken, of which 1301 had hyperprolactinaemia not related to pregnancy: 25·6% patients had pituitary disorder, 45·9% were drug‐induced, 7·5% had macroprolactin and 6·1% had hypothyroidism, leaving 15·0% idiopathic. Over the 20 years, there was a fourfold increase in the number of prolactin assays performed, and prevalence of hyperprolactinaemia was initially 0·02%, but rose to 0·23% by 2013. Overall incidence was 13·8 cases per 100000 person‐years (20·6 in 2008–13) and was 3·5 times higher in women than in men. The highest rates were found in women aged 25–44 years. Drug‐induced causes tripled during the 20 years. Conclusions Rising prevalence of hyperprolactinaemia is probably due to an increased ascertainment and increased incidence of psychoactive drug‐related causes. Rates are higher in women than in men but only before the age of 65 years.