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. 2026 Jan 14.
doi: 10.1111/cen.70095. Online ahead of print.

Sex- and Age-Specific Metabolic Outcomes of Prolactin Normalisation in Hyperprolactinaemia

Pedro Iglesias  1   2 , María Dolores Moure Rodríguez  3 , Fernando Guerrero-Pérez  4 , Andreu Simó-Servat  5 , Laura González Fernández  6 , Eva Fernández-Rodríguez  7 , Patricia Pérez Castro  8 , Rocío Villar-Taibo  9 , Betina Biagetti  10 , Aida Orois  11 , Sara de Miranda Lemos Donato  12 , Victoria Alcázar Lázaro  13 , Noel Roig-Marín  14 , Guillermo Serra  15 , Soralla Civantos  16 , Gonzalo Rivero  1 , Carmen María Fernandez de Araoz  17 , Isabel Pavón de Paz  17 , Elena Outeiriño-Blanco  18 , Fernando Cordido  18 , Rogelio García Centeno  6 , Marta Araujo-Castro  12 , Cristina Lamas  14 , Miguel Paja  19 , Felicia Alexandra Hanzu  20 , Juan J Díez  1   2
Affiliations

Sex- and Age-Specific Metabolic Outcomes of Prolactin Normalisation in Hyperprolactinaemia

Pedro Iglesias et al. Clin Endocrinol (Oxf). .

Abstract

Background: Hyperprolactinaemia has been linked to adverse metabolic profiles, but the metabolic consequences of prolactin (PRL) normalisation remain insufficiently characterised.

Objective: To evaluate changes in anthropometric, blood pressure, and metabolic parameters following PRL normalisation, with analyses stratified by sex and age.

Methods: We retrospectively analysed 445 patients (286 women, 159 men) treated with cabergoline who had paired clinical and biochemical measurements before and after PRL normalisation. Pre-post differences were assessed overall and stratified by sex and age (< 50 vs. ≥ 50 years). Additional multivariable models examined independent predictors of metabolic changes.

Results: Men exhibited more severe baseline disease, including higher PRL levels, greater prevalence of macroadenomas, hypopituitarism, and cardiometabolic comorbidities. After PRL normalisation, body weight, BMI, and blood pressure showed no clinically relevant changes. Small but statistically significant reductions were observed in total cholesterol (185 → 181 mg/dL; p < 0.001), LDL-C (110 → 106 mg/dL; p = 0.038), and triglycerides (91 → 82 mg/dL; p < 0.001). These lipid changes, however, were not independently explained by sex, age, PRL dynamics, cabergoline exposure, or gonadal status in multivariable analyses. Fasting glucose and HDL-C remained largely unchanged. By contrast, the TyG index decreased significantly across sexes and age groups, and multivariable modelling identified higher initial cabergoline dose and baseline hypogonadism as independent determinants of greater TyG reduction.

Conclusions: PRL normalisation with cabergoline was associated with modest improvements in conventional lipid fractions and a more consistent reduction in the TyG index, suggesting a preferential impact on insulin-resistance-related pathways. The absence of independent effects of sex, age, PRL dynamics, or cabergoline exposure on lipid changes underscores the need for cautious interpretation of statistically significant but small absolute shifts.

Keywords: cardiometabolic risk; dopamine agonists; hyperprolactinaemia; lipids; prolactin; sex characteristics.

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