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Bone density in women with prolactinoma treated with dopamine agonists

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Abstract

Objectives (1) to evaluate bone density in women with prolactinoma treated with dopamine agonists and healthy controls, using dual energy x-ray absorptiometry (DXA), (2) to classify the results according to the current International Society for Clinical Densitometry (ISCD) criteria, and (3) to correlate bone density with lean and fat masses, biochemical data and clinical aspects of prolactinomas. Materials and methods A cross-sectional study was performed in two University referral centers. Forty-five premenopausal women with prolactinoma were submitted to DXA and blood analysis (prolactin, estradiol, testosterone, SHBG, calcium, phosphorus, PTH, C-telopeptides of type 1 collagen, and osteocalcin) by the time of their clinical evaluation. They were compared with 25 control women of similar age and body mass index distribution. Results Women with prolactinoma had lower lumbar spine Z-score than controls. Femoral neck, trochanter, and total proximal femur Z-scores were similar in patients and controls. Twenty-two percent of the patients had Z-scores below the expected age range vs. 4% in the control group. Lumbar spine, femoral neck, and total proximal femur Z-scores were mainly correlated with the amenorrhea duration. The trochanter Z-score was associated with the gynoid lean/fat mass ratio. Conclusions Based on the current ISCD criteria, bone density evaluation in women with prolactinoma reveals bone loss, especially of trabecular type. Bone density in these patients was particularly associated with the duration of amenorrhea, which reinforces the importance of the adequate disease control in women with prolactinoma in order to avoid complications of this disease.

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Abbreviations

NPNE:

Patients with normal PRL and estradiol levels

EPNE:

Patients with elevated PRL and normal estradiol levels

EPLE:

Patients with elevated PRL and low estradiol levels

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Acknowledgments

We thank the Ministry of Education of Brazil through CAPES (Coordination of Personal Development—Post-graduation Level) for supporting this work in form of Ph.D and MSc scholarships for E.C.O. Naliato and A. Lamounier Filho, respectively. We also thank FAPERJ (Carlos Chagas Filho Research Support Foundation of Rio de Janeiro) for supporting this work in form of a research grant.

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Authors and Affiliations

  1. Division of Endocrinology, Department of Internal Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

    Erika Cesar de Oliveira Naliato, Alice Helena Dutra Violante, Maria Lucia Fleiuss Farias, Isabela Bussade, Adilson Lamounier Filho & Christiane Rezende Loureiro

  2. Hyperprolactinemia Unit, Clementino Fraga Filho University Hospital (HUCFF), Rio de Janeiro, Brazil

    Erika Cesar de Oliveira Naliato, Alice Helena Dutra Violante, Maria Lucia Fleiuss Farias, Isabela Bussade, Adilson Lamounier Filho & Christiane Rezende Loureiro

  3. Av Lucio Meira 670/517—Centro, Teresopolis, 25953-003, RJ, Brazil

    Erika Cesar de Oliveira Naliato

  4. Pituitary Unit, Luiz Capriglione State Institute of Diabetes and Endocrinology/Rio de Janeiro (IEDE), Rio de Janeiro, Brazil

    Dayse Caldas

  5. Diagnósticos da America S/A, Rio de Janeiro, Brazil

    Rosita Fontes & Yolanda Schrank

  6. Medical School, UFRJ, Rio de Janeiro, Brazil

    Thaissa Loures

  7. Section of Endocrinology, Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy

    Annamaria Colao

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  1. Erika Cesar de Oliveira Naliato
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  2. Alice Helena Dutra Violante
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  3. Dayse Caldas
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  4. Maria Lucia Fleiuss Farias
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  5. Isabela Bussade
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  6. Adilson Lamounier Filho
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  7. Christiane Rezende Loureiro
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  8. Rosita Fontes
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  9. Yolanda Schrank
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  10. Thaissa Loures
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  11. Annamaria Colao
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Correspondence to Erika Cesar de Oliveira Naliato.

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Naliato, E.C.O., Violante, A.H.D., Caldas, D. et al. Bone density in women with prolactinoma treated with dopamine agonists. Pituitary 11, 21–28 (2008). https://doi.org/10.1007/s11102-007-0064-4

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