The effect of hypoprolactinemia on cardiometabolic effects of rosuvastatin in men: A matched Cohort Pilot Study.

PURPOSE: Low prolactin levels are associated with an increased risk of vascular and metabolic diseases. Women with prolactin deficiency appear to have attenuated responses to lipid-lowering and insulin-sensitizing medications. This study aimed to evaluate the impact of hypoprolactinemia on the cardiometabolic effects of rosuvastatin in men.

METHODS

Three groups of men with indications for statin therapy were included. Group 1 comprised 16 individuals with prolactin levels below 3 ng/mL, while groups 2 (n = 23) and 3 (n = 37) included patients with levels between 3 and 20 ng/mL. Participants in groups 1 and 2 were chronically treated with cabergoline. Throughout the six-month study period, all patients received rosuvastatin. In addition to lipid profile and prolactin levels, assessed parameters included high-sensitivity C-reactive protein (hs-CRP), fibrinogen, homocysteine, uric acid, urinary albumin-to-creatinine ratio (UACR), carbohydrate metabolism markers, testosterone, and carotid intima-media thickness (CIMT).

RESULTS

At baseline, men with hypoprolactinemia showed higher hs-CRP, fibrinogen, homocysteine, UACR, HbA1c, and HOMA-IR, and lower testosterone than those with normal prolactin levels. Rosuvastatin reduced total and LDL cholesterol in all groups, with a greater effect in groups 2 and 3. Reductions in hs-CRP, fibrinogen, uric acid, homocysteine, and UACR occurred only in groups with normal prolactin. Group 1 exhibited increases in HbA1c and HOMA-IR. At study end, CIMT was greater in group 1 than in groups 2 and 3, whereas the latter two groups had comparable values. In men with hypoprolactinemia, the effects of rosuvastatin on total and LDL cholesterol, hs-CRP, fibrinogen, uric acid, homocysteine, UACR, HbA1c, HOMA-IR, and CIMT correlated with baseline and posttreatment prolactin concentrations.

CONCLUSION

These findings suggest that hypoprolactinemia may worsen cardiometabolic outcomes in men receiving rosuvastatin therapy.