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Vertebral fractures in males with prolactinoma

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Abstract

Data on osteoporotic fractures in hyperprolactinemia are limited. An increased prevalence of radiological vertebral fractures was recently observed in women with prolactin (PRL)-secreting adenoma, whereas it is unknown whether this observation may reflect a more general increased risk of fractures in this disease and whether the prevalence of fractures in males is affected by gonadal status. Thirty-two males (median age 47 years, range: 22–79) with PRL-secreting pituitary adenoma (10 with microadenoma and 22 with macroadenoma) and 64 control males, with normal PRL values and with comparable age to patients with hyperprolactinemia, were evaluated for vertebral fractures by a morphometric approach and for bone mineral density (BMD) by a dual-energy X-ray absorptiometry at lumbar spine. Vertebral fractures were shown in 12 patients with PRL-secreting adenoma (37.5%) and in 5 controls (7.8%, P < 0.001). Fractured patients had lower BMD T-score (P = 0.007) and longer duration of disease (P < 0.001) as compared to patients who did not fracture. Fractures occurred more frequently (P = 0.03) in patients with untreated hyperprolactinemia versus patients treated with cabergoline whose frequency of vertebral fractures was still higher than control subjects. The prevalence of vertebral fractures was not significantly different between eugonadal and hypogonadal patients (33.3% vs. 38.5%; P = 0.8). Moreover, no significant (P = 0.4) difference in serum testosterone values was found between fractured and not fractured males. Hyperprolactinemia is associated with high prevalence of radiological vertebral fractures in men with PRL-secreting adenoma. These findings would also suggest that PRL excess may produce negative skeletal effects independently of hypogonadism.

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Funding

Study partially supported by MIUR, EULO and Centro Ricerca Sull’Osteoporosi-University of Brescia.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy

    Gherardo Mazziotti, Teresa Porcelli, Carola Mejia & Andrea Giustina

  2. Department of Medicine, “Carlo Poma” Hospital, 46100, Mantua, Italy

    Gherardo Mazziotti

  3. Department of Endocrinology, Pituitary Unit, Catholic University of Rome, Rome, Italy

    Marilda Mormando, Antonio Bianchi & Laura De Marinis

  4. Department of Medicine, General Hospital of Montebelluna, Treviso, Italy

    Ernesto De Menis

  5. Department of Internal Medicine and Medical Specialities, San Marino Hospital, San Marino, San Marino

    Tatiana Mancini

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  1. Gherardo Mazziotti
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Correspondence to Gherardo Mazziotti.

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Mazziotti, G., Porcelli, T., Mormando, M. et al. Vertebral fractures in males with prolactinoma. Endocr 39, 288–293 (2011). https://doi.org/10.1007/s12020-011-9462-5

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