Glucose-Lipid Metabolism in Obesity with Elevated Prolactin Levels and Alteration of Prolactin Levels After Laparoscopic Sleeve Gastrectomy

Abstract
Purpose We investigated the differences in metabolism between obesity with or without increased prolactin (PRL) and the change in PRL after laparoscopic sleeve gastrectomy (LSG). Methods Patients were divided into two groups: obesity with normal PRL (NP,n = 123) and high PRL (HP,n = 108). Glucose-lipid metabolism and inflammation were measured. A total of 115 patients with obesity (NP,n = 64; HP,n = 51) underwent LSG were recruited, and PRL was measured at 12 months after LSG. Results (1) Blood glucose (BG), total cholesterol (TCH), LDL, triglyceride, and TNF-alpha were lower in the HP than in the NP group in the cross-sectional study (allP < 0.05). (2) PRL was negatively associated with neck circumference, waist-to-hip ratio, systolic blood pressure, heart rate, basal metabolism rate (BMR), ALP, TCH, and LDL in all subjects. PRL levels were positively associated with weight, HC, and BMR in males but were negatively associated with ALT, AST, ALP, BG 30 min, BG 60 min, FFA, and TCH in females (allP < 0.05). (3) Regression analysis showed that PRL negatively correlated with ALP and LDL-C in the whole baseline (beta = - 0.051,P = 0.002;beta = - 1.372,P = 0.033). PRL was a negative factor for ALP in females and a positive factor for BMR2 in males (beta = - 0.099,P = 0.041;beta = 0.005,P = 0.006). (4) PRL decreased in the HP group and increased in the NP group at 12 months post-operation (allP < 0.05). Increased PRL was associated with a change in TCH in the NP group (P < 0.05). Conclusion Increased PRL resulted in improved glucose-lipid metabolism and chronic low-grade inflammation. LSG led to increased PRL in NP and decreased PRL in HP. Improved lipid was associated with increased PRL in NP after surgery.

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