Diabetes research and clinical practice · 2025
Low prolactin levels as a marker of gestational diabetes in late pregnancy.
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Scairati Roberta, Auriemma Renata S, Meglio Sara Di, Mastantuoni Enrica, Graziadio Chiara, Vecchio Guendalina Del, Legnante Antonietta, McEvoy Robert P, Newman Christine, Dunne Fidelma, Pivonello Rosario, Spiezio Sardo Attilio Di, Colao Annamaria
Аннотация
AIMS: Beyond its known role in lactation, prolactin is emerging as a hormone involved in gestational glucose metabolism. This study aimed to assess prolactin trajectories across pregnancy and their association with metabolic outcomes, including gestational diabetes (GDM).
METHODS: A longitudinal cohort of 120 pregnant women (67 with GDM, 53 non-GDM) was followed throughout gestation. Prolactin, fasting glucose, insulin, and HbA1c were measured each trimester and GDM diagnosed by 75-g oral glucose tolerance test. Postpartum follow-up included breastfeeding and glucose tolerance assessment. Multivariable logistic regression and ROC curve analyses were used to estimate the independent association between third-trimester prolactin and GDM.
RESULTS: Prolactin levels were significantly lower in the third trimester in women with GDM (p = 0.027). First-trimester prolactin inversely correlated with fasting glucose (p = 0.02;r = -0.4), while second-trimester values with HbA1c in mid- (p = 0.035;r = -0.5) and late gestation (p < 0.001;r = -0.9). Third-trimester prolactin independently predicted 2-hour glucose post-load (t = -2,5;p = 0.03). A threshold of < 182 μg/L showed 59.5 % sensitivity and 90 % specificity for identifying GDM (AUC = 0.72 ± 0.087,p = 0.009). Logistic regression confirmed this association (p = 0.034).
CONCLUSIONS: Lower third-trimester prolactin levels are independently associated with GDM and may serve as a hormonal marker of impaired metabolic adaptation. Serial prolactin profiling could aid in endocrine-based risk stratification.
METHODS: A longitudinal cohort of 120 pregnant women (67 with GDM, 53 non-GDM) was followed throughout gestation. Prolactin, fasting glucose, insulin, and HbA1c were measured each trimester and GDM diagnosed by 75-g oral glucose tolerance test. Postpartum follow-up included breastfeeding and glucose tolerance assessment. Multivariable logistic regression and ROC curve analyses were used to estimate the independent association between third-trimester prolactin and GDM.
RESULTS: Prolactin levels were significantly lower in the third trimester in women with GDM (p = 0.027). First-trimester prolactin inversely correlated with fasting glucose (p = 0.02;r = -0.4), while second-trimester values with HbA1c in mid- (p = 0.035;r = -0.5) and late gestation (p < 0.001;r = -0.9). Third-trimester prolactin independently predicted 2-hour glucose post-load (t = -2,5;p = 0.03). A threshold of < 182 μg/L showed 59.5 % sensitivity and 90 % specificity for identifying GDM (AUC = 0.72 ± 0.087,p = 0.009). Logistic regression confirmed this association (p = 0.034).
CONCLUSIONS: Lower third-trimester prolactin levels are independently associated with GDM and may serve as a hormonal marker of impaired metabolic adaptation. Serial prolactin profiling could aid in endocrine-based risk stratification.