Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society · 2025
Dynamic changes in IGF-1 levels during cabergoline therapy in prolactinoma.
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Demir Ahmet Numan, Birol Alara, Ozaydin Dilan, Kara Zehra, Sahin Serdar, Kadioglu Pinar
Аннотация
BACKGROUND: Cabergoline, a dopamine agonist widely used in prolactinoma treatment, also suppresses growth hormone (GH) and insulin-like growth factor-1 (IGF-1), though its long-term effects on IGF-1 levels in prolactinoma remain unclear.
OBJECTIVE: To evaluate changes in IGF-1 levels and influencing factors in prolactinoma patients treated with cabergoline.
METHODS: This retrospective cohort study included 127 prolactinoma patients treated with cabergoline between 2013 and 2023. Patients with conditions affecting IGF-1 (e.g., hypopituitarism, organ dysfunction, hormone replacement therapy) were excluded. IGF-1 and IGF-1xULN levels were compared at baseline and last follow-up. Associations with treatment duration, cumulative cabergoline dose, and tumor features were assessed using regression and ROC analyses.
RESULTS: The median follow-up was 36 [IQR: 18-60] months. Final IGF-1 and IGF-1xULN levels were significantly lower than baseline (p = 0.002 and p = 0.045). IGF-1xULN increased in 44.9 % and decreased in 55.1 % of patients, but all values remained within normal limits. Decreased IGF-1xULN was associated with longer treatment duration and higher cumulative doses (p < 0.05). ROC analysis identified ≥60 mg cumulative dose and ≥ 18 months treatment duration as predictors of IGF-1 reduction (AUROC ≈ 0.70).
CONCLUSION: Cabergoline therapy in prolactinoma may result in an early rise and subsequent decline in IGF-1 levels. The clinical significance of within-range IGF-1 reductions remains uncertain and requires prospective studies with predefined metabolic endpoints.
OBJECTIVE: To evaluate changes in IGF-1 levels and influencing factors in prolactinoma patients treated with cabergoline.
METHODS: This retrospective cohort study included 127 prolactinoma patients treated with cabergoline between 2013 and 2023. Patients with conditions affecting IGF-1 (e.g., hypopituitarism, organ dysfunction, hormone replacement therapy) were excluded. IGF-1 and IGF-1xULN levels were compared at baseline and last follow-up. Associations with treatment duration, cumulative cabergoline dose, and tumor features were assessed using regression and ROC analyses.
RESULTS: The median follow-up was 36 [IQR: 18-60] months. Final IGF-1 and IGF-1xULN levels were significantly lower than baseline (p = 0.002 and p = 0.045). IGF-1xULN increased in 44.9 % and decreased in 55.1 % of patients, but all values remained within normal limits. Decreased IGF-1xULN was associated with longer treatment duration and higher cumulative doses (p < 0.05). ROC analysis identified ≥60 mg cumulative dose and ≥ 18 months treatment duration as predictors of IGF-1 reduction (AUROC ≈ 0.70).
CONCLUSION: Cabergoline therapy in prolactinoma may result in an early rise and subsequent decline in IGF-1 levels. The clinical significance of within-range IGF-1 reductions remains uncertain and requires prospective studies with predefined metabolic endpoints.