Follow-up of hypogonadotropic hypogonadism recovery in Chinese male prolactinoma patients treated with dopamine agonists.

PURPOSE: To evaluate the prevalence of hypogonadotropic hypogonadism (HH) in male prolactinoma patients with dopamine agonist (DA) therapy and explore the predictive factors of hypogonadism recovery. DESIGN: Retrospective study from a single center. METHODS: A cohort of male prolactinoma patients who were under medical therapy for at least one year with regular follow-up from the special outpatient clinic in Huashan Hospital was reviewed. Demographic details, clinical features, hormonal profile, medication, imaging characteristics were recorded at diagnosis and during the timeline follow-up. FINDINGS: A total of 73 male prolactinoma patients with median age of 35 (31–51) years old, and BMI of 24.9 ± 2.7 kg/m2 were included. The prevalence of HH at diagnosis was 87.7%. After 2.5 (1.5–3.4) years of DA therapy, 71.4% of HH patients recovered after prolactin normalization. Compared to those with persistent HH, patients with HH recovery had lower baseline BMI (24.2 ± 2.4 vs. 26.4 ± 2.7 kg/m2, p = 0.002), and higher baseline testosterone (4.28 [3.32–6.03] vs. 2.34 [1.36–4.35] nmol/L, p = 0.007). The multivariate logistic regression analysis demonstrated that patients with higher testosterone level (OR 1.679 [1.134–2.487]) or lower BMI (OR 0.761 [0.592–0.977]) at diagnosis had significantly greater possibility of HH recovery, after adjusting for prolactin, adenoma maximal diameter and vision changes. CONCLUSIONS: HH is common in male prolactinoma patients and 71.4% of them recovered from HH after prolactin normalization treated by DA. Baseline testosterone and BMI were identified as independent predictors of HH recovery in men with prolactinoma.