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Neuroendocrinology and Pituitary

MON-118 - Should Hyperprolactinemia Only Be Monitored in Postmenopausal Patients with Prolactinoma? A Study on Metabolic and Cardiovascular Evaluation in A Cohort of Patients

Monday, June 15, 2026
9:00 AM - 2:00 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Mariana Ramos de Santana, MD: No financial relationships to disclose
Ana Claudia Latronico, MD, PhD: No financial relationships to disclose
Prolactinomas are the most common type of pituitary tumor and a significant cause of hypogonadism. In addition to their reproductive effects, hyperprolactinemia has been linked to negative metabolic and cardiovascular (CV) profiles, which may improve with dopamine agonist (DA) therapy. Currently, routine treatment is not recommended for postmenopausal women with microprolactinomas. However, recent data suggest that persistent hyperprolactinemia may have metabolic implications. This study aimed to evaluate components of metabolic syndrome (MS) and CV risk in postmenopausal women with prolactinoma by comparing women with normal prolactin (PRL) levels to those with elevated levels, using matched controls based on body mass index (BMI) and time since menopause. Exclusion criteria included radiotherapy for prolactinoma, smoking, hormone replacement therapy, and previous CV events.
Seventy postmenopausal women (less than 10 years since menopause) participated in the study: 32 with prolactinoma (Group P) and 38 controls (Group C), both groups matched for age and BMI. All patients in Group P had been off DA for at least 6 months, with stable tumor size and PRL levels. They were classified based on their serum PRL levels into high PRL (N=13) or normal PRL (N=19). We analyzed pituitary function, metabolic (weight, BMI, Lp (a), blood glucose, glycated hemoglobin, leptin, adiponectin, cholesterol, triglycerides), inflammatory and CV biomarkers. MS was evaluated according to the IDF criteria, and CV risk was assessed using the PREVENT 2023 calculator. Multivariate regression models were adjusted for age, BMI, diabetes, hypertension, dyslipidemia, and time since menopause.
There was no significant difference between Groups P and C regarding blood glucose, cholesterol, triglycerides, Lp(a), diabetes or MS. However, Group P exhibited significantly higher leptin levels than the controls after adjustments (R² = 0.59; p < 0.001) and a positive correlation was found between leptin and PRL (rho = 0.25; p = 0.03). This correlation remained significant when comparing only the hyperprolactinemic patients with the controls (R² = 8.16; p = 0.004). Moreover, increased CV risk (≥ 10% over 10 years) was observed exclusively in the high PRL subgroup compared with controls (p = 0.046).
Postmenopausal women with prolactinoma displayed higher leptin levels unrelated to PRL levels. Elevated leptin levels are typically associated with obesity and MS. In addition, high PRL levels correlated with increased CV risk, as assessed by the PREVENT 2023 calculator. These finding warrants confirmation through CV examinations and more precise risk stratification. While further studies are needed to validate our results, assessing metabolic and CV risk may be important for postmenopausal women with prolactinoma.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*