Hyperprolactinaemia is suggested to be associated with metabolic and hormonal complications. No previous study has compared the effect of different
dopamine agonists on plasma
lipids, carbohydrate metabolism markers and cardiovascular risk factors in patients with elevated
prolactin levels. The study included eight
bromocriptine-resistant women with
prolactinoma (group 1) and twelve matched women with
hyperprolactinaemia unrelated to
prolactinoma (group 2). Group 1 was then treated with
cabergoline, while group 2 with
bromocriptine. Plasma
lipids,
glucose homeostasis markers and plasma levels of
prolactin,
insulin-like growth factor-1 (IGF-1) and cardiovascular risk factors were assessed before and after 6 months of
therapy. Both treatments normalized plasma
prolactin levels.
Cabergoline reduced
triglycerides, 2-hr post-challenge plasma
glucose, the homeostatic model assessment of
insulin resistance (HOMA-IR), and circulating levels of
IGF-1,
free fatty acids (FFA),
uric acid,
high-sensitivity C-reactive protein (
hsCRP),
homocysteine and
fibrinogen, as well as increased
HDL cholesterol and
25-hydroxyvitamin D. With the exception of a reduction in HOMA-IR,
bromocriptine treatment produced no significant effect on the investigated
biomarkers.
Cabergoline was superior to
bromocriptine in affecting 2-hr post-challenge plasma
glucose levels, HOMA-IR, as well as circulating levels of
IGF-1, FFA,
uric acid,
hsCRP,
homocysteine,
fibrinogen and
25-hydroxyvitamin D. Our results may suggest that
cabergoline is superior to
bromocriptine when it comes to affecting atherogenic dyslipidaemia,
insulin sensitivity and circulating levels of cardiovascular risk factors in hyperprolactinaemic patients. These findings seem to support previous observations that
cabergoline may be a better treatment for patients with elevated
prolactin levels than
bromocriptine.