Bone Marker and Bone Density Responses to Dopamine Agonist Therapy in Hyperprolactinemic Males
Abstract
The aim of this prospective study was to evaluate the bone mineral density (BMD) at lumbar spine and femoral neck levels and biochemical parameters of bone turnover in 20 consecutive hyperprolactinemic males before and after an 18-month treatment with different dopamine agonists. Six patients received bromocriptine at a dose of 2.5-10 mg/day; 7 patients received quinagolide at a dose of 0.075-0.3 mg/day; 7 patients received cabergoline at a dose of 0.5-1.5 mg/week. BMD, serum PRL, testosterone, dihydrotestosterone, and osteocalcin (OC), and urinary cross-linked N-telopeptides of type I collagen (Ntx) levels were measured before and every 6 months during treatment. At study entry, BMD values were lower in patients than controls at both lumbar spine (0.82 +/- 0.03 vs. 1.18 +/- 0.01 g/cm2; P < 0.001) and femoral neck (0.85 +/- 0.02 vs. 0.92 +/- 0.02 g/cm2; P < 0.05) levels. Osteopenia or osteoporosis was diagnosed in 16 patients at the lumbar spine and in 6 of them at the femoral neck level. A significant inverse correlation was found between lumbar spine and femoral neck BMD values and both PRL levels and disease duration (P < 0.01). In the 20 patients, serum OC levels were significantly lower (2.1 +/- 0.1 vs. 9.3 +/- 2.4 microg/L; P < 0.01), whereas Ntx levels were significantly higher (157.8 +/- 1.1 vs. 96.4 +/- 7.4 nmol bone collagen equivalent/mmol creatinine; P < 0.001) than control values. A significant inverse correlation was found between serum PRL and OC (P < 0.01), bu…
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Patients who developed hyperprolactinemia in childhood or adolescence have more severe bone impairment than subjects who developed hyperprolactinemia in adulthood.
“Patients who developed hyperprolactinemia in childhood or adolescence have more severe bone impairment than subjects who developed hyperprolactinemia in adulthood [20, 22].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
Lumbar spine and femoral neck BMD values are negatively correlated with prolactin levels and disease duration in hyperprolactinemia.
“A significant negative correlation was found between lumbar spine and femoral neck BMD values and both prolactin (PRL) levels and disease duration, which suggests that the duration of the disease is strongly correlated with the severity of bone loss [20, 22].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
In one study, all patients had significantly lower osteocalcin levels and significantly higher urinary Ntx levels, but BMD values were in normal ranges in 20% of the patients.
“In one study, in all patients, osteocalcin (OC) levels were significantly lower and urinary cross-linked N-telopeptide of type I collagen (Ntx) levels were significantly higher; however BMD values were in normal ranges in 20% of the patients [20].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
Dopamine agonist therapy restores gonadal function and increases vertebral BMD in most hyperprolactinemic women.
“Dopamine agonist therapy restores gonadal function and increases vertebral BMD in most hyperprolactinemic women [19, 20].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
In hyperprolactinemic males, low BMD at the lumbar spine was found in 80% of patients, whereas only 30% had reduced BMD at the femoral neck; a similar finding was reported in women.
“A study on hyperprolactinemic males showed low BMD at the lumbar spine in 80% of patients, whereas only 30% subjects had a reduced BMD at the femoral neck. Similar finding was reported in women [20].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
After 6, 12, and 18 months of treatment, serum osteocalcin levels significantly increased and Ntx levels significantly decreased in the three groups of patients.
“A progressive significant increase in serum OC levels and a significant decrease in Ntx levels were noted after 6, 12, and 18 months of treatment in the 3 groups of patients.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
18-month treatment with bromocriptine, quinagolide, or cabergoline normalized serum PRL and osteocalcin levels and gonadal function, although it was unable to completely restore lumbar spine and femoral neck BMD and normalize Ntx levels.
“18-month treatment with one of the dopamine agonists (bromocriptine, quinagolide, or cabergoline) normalized serum PRL and OC levels and gonadal function, although it was unable to completely restore lumbar spine and femoral neck BMD and normalize Ntx levels [20].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
Increase in bone resorption and low BMD occur in males and females with hyperprolactinemia.
“Increase in bone resorption and low BMD occur in males and females with hyperprolactinemia [18, 20–23].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [20]
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Prevalence of osteopenia in men with prolactinoma
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Glucose Metabolism in Osteoblasts in Healthy and Pathophysiological Conditions
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- Authors
- Di Somma, C.
- Venue
- Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 1998-03-01
- Volume
- 83
- Issue
- 3
- Pages
- 807-813
- ISSN
- 0021-972X (ISSN-L)
- OpenAlex
- W2164331064
- Cited by
- 117
- References
- 1
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 1 · 2022: 7 · 2021: 8 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 4 · 2012: 6
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- hyperprolactinemia, dopamine agonist therapy, bone mineral density, bone turnover markers, bromocriptine, quinagolide, cabergoline, osteopenia, osteoporosis, prolactin, osteocalcin, N-terminal telopeptide of type I collagen, testosterone, gonadal function, male patients, lumbar spine, femoral neck, disease duration
- MeSH terms
- Cabergoline, Adult, Aminoquinolines, Bone and Bones, Bone Diseases, Metabolic, Bromocriptine, Ergolines, Humans, Hyperprolactinemia, Male, Middle Aged, Prospective Studies, Biomarkers, Bone Density, Bone Remodeling, Dopamine Agonists
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