Prolactin is Associated with Bone Mineral Density in Subjects with Type 2 Diabetes Mellitus

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2022 Oct 31

PMID 36313749

Authors

Jia Chen

Geng Liu

Quan Li

Wei Deng

Affiliations

Soon will be listed here.

Abstract

Purpose: Prolactin (PRL) exerts actions in the bone besides lactation and reproduction. This study aimed to investigate whether PRL is related to bone mineral density (BMD) in type 2 diabetes mellitus (T2DM).

Methods: A total of 642 patients with T2DM were divided into two groups with age and body mass index (BMI) matched: mildly increased PRL (HP group, n = 101) or normal PRL (NP group, n = 541). BMD was measured by dual-energy X-ray absorptiometry and compared.

Results: 1) BMD, T score at lumbar spine L1-4, right hip and femur neck, and Z score at the femur neck were significantly higher in the HP than in the NP group (0.96 ± 0.16 vs. 0.92 ± 0.15g/cm, p = 0.019; 0.88 ± 0.15vs. 0.84 ± 0.14 g/cm, p = 0.007; 0.75 ± 0.17 vs.0.70 ± 0.13 g/cm, p = 0.001; -0.90 (-1.85, -0.20) vs. -1.40 (-2.20, -0.40), p = 0.018; -0.80 (-1.50, -0.30) vs. -1.10 (-1.80, -0.53), p = 0.026; -1.30 (-2.00, -0.60) vs. -1.70 (-2.20, -1.00), p = 0.001; -0.20 (-0.70, 0.30) vs. -0.40 (-0.90, 0.10), p = 0.026). In men, T and Z scores at the right hip and femur neck were significantly higher in the HP than in the NP group (-0.70 (-1.32, 0.20) vs. -0.90 (-1.50, -0.40), p = 0.038; -0.20 (-0.80, 0.20) vs. -0.50 (-0.10, 0.10), p = 0.027; -0.30 (-0.60, -0.30) vs. -0.40 (-0.90, 0.20), p = 0.038) but not in women. Bone turnover markers have no significant difference between groups (all p > 0.05). 2) BMD at the right hip and Z score at the right hip and femur neck were significantly positively associated with PRL ( = 0.087, p = 0.029; = 0.089, p = 0.024; = 0.087, p = 0.029). In men, BMD at L1-4 and the right hip; T score at L1-4, the right hip, and the femur neck; and Z score at the right hip and the femur neck were significantly positively associated with PRL ( = 0.122, p = 0.007; = 0.105, p = 0.041; = 0.123, p = 0.016; = 0.110, p = 0.032; = 0.115, p = 0.025; = 0.121, p = 0.018; = 0.138, p = 0.007) but not significant in women. 3) In men divided into two groups according to T score (T score at the right hip>-1 or T score at the right hip≤-1) or the median BMD at L1-4, the right hip or the femur neck, PRL was significantly higher in the higher BMD than in the lower BMD group (16.32 ± 6.12 vs. 14.78 ± 5.68 ng/ml, p = 0.012; 16.20 ± 6.21 vs. 14.73 ± 5.40 ng/ml, p = 0.014; 16.10 ± 6.01 vs. 14.80 ± 5.77 ng/ml, p = 0.032; 16.17 ± 6.04 vs. 14.76 ± 5.77 ng/ml, p = 0.02; 16.48 ± 6.05 vs. 14.98 ± 5.81 ng/ml, p = 0.020; 16.10 ± 5.98 vs. 14.80 ± 5.87 ng/ml, p = 0.035).

Conclusion: Increased PRL was associated with better BMD in patients with T2DM, especially in men. PRL within the biologically normal range may play a protective role in the BMD of T2DM.

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References

Starup-Linde J, Vestergaard P . Biochemical bone turnover markers in diabetes mellitus - A systematic review. Bone. 2015; 82:69-78. DOI: 10.1016/j.bone.2015.02.019. View

Jiao H, Xiao E, Graves D . Diabetes and Its Effect on Bone and Fracture Healing. Curr Osteoporos Rep. 2015; 13(5):327-35. PMC: 4692363. DOI: 10.1007/s11914-015-0286-8. View

Colao A, Di Somma C, Loche S, Di Sarno A, Klain M, Pivonello R . Prolactinomas in adolescents: persistent bone loss after 2 years of prolactin normalization. Clin Endocrinol (Oxf). 2000; 52(3):319-27. DOI: 10.1046/j.1365-2265.2000.00902.x. View

Saki F, Sadeghian F, Kasaee S, Talezadeh P, Omrani G . The effect of prolactin itself and in combination with estrogen on bone mineral density in female rats. Gynecol Endocrinol. 2019; 35(6):539-543. DOI: 10.1080/09513590.2018.1548592. View

Napoli N, Chandran M, Pierroz D, Abrahamsen B, Schwartz A, Ferrari S . Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2016; 13(4):208-219. DOI: 10.1038/nrendo.2016.153. View

Radojkovic D, Pesic M, Radojkovic M, Dimic D, Nikolic M, Jevtovic Stoimenov T . Expression of prolactin receptors in the duodenum, kidneys and skeletal system during physiological and sulpiride-induced hyperprolactinaemia. Endocrine. 2018; 62(3):681-691. DOI: 10.1007/s12020-018-1730-1. View

Halbreich U, Kinon B, Gilmore J, Kahn L . Elevated prolactin levels in patients with schizophrenia: mechanisms and related adverse effects. Psychoneuroendocrinology. 2002; 28 Suppl 1:53-67. DOI: 10.1016/s0306-4530(02)00112-9. View

Li J, Rice M, Huang T, Hankinson S, Clevenger C, Hu F . Circulating prolactin concentrations and risk of type 2 diabetes in US women. Diabetologia. 2018; 61(12):2549-2560. PMC: 6309828. DOI: 10.1007/s00125-018-4733-9. View

Lennartsson A, Jonsdottir I . Prolactin in response to acute psychosocial stress in healthy men and women. Psychoneuroendocrinology. 2011; 36(10):1530-9. DOI: 10.1016/j.psyneuen.2011.04.007. View

10.

Vaidya V, Gangan N, Sheehan J . Impact of cardiovascular complications among patients with Type 2 diabetes mellitus: a systematic review. Expert Rev Pharmacoecon Outcomes Res. 2015; 15(3):487-97. DOI: 10.1586/14737167.2015.1024661. View

11.

Vestergaard P . Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int. 2006; 18(4):427-44. DOI: 10.1007/s00198-006-0253-4. View

12.

Doknic M, Maric N, Britvic D, Pekic S, Damjanovic A, Miljic D . Bone remodeling, bone mass and weight gain in patients with stabilized schizophrenia in real-life conditions treated with long-acting injectable risperidone. Neuroendocrinology. 2011; 94(3):246-54. DOI: 10.1159/000329391. View

13.

. 2. Classification and Diagnosis of Diabetes: . Diabetes Care. 2019; 43(Suppl 1):S14-S31. DOI: 10.2337/dc20-S002. View

14.

Paschou S, Dede A, Anagnostis P, Vryonidou A, Morganstein D, Goulis D . Type 2 Diabetes and Osteoporosis: A Guide to Optimal Management. J Clin Endocrinol Metab. 2017; 102(10):3621-3634. DOI: 10.1210/jc.2017-00042. View

15.

Zheng Y, Ley S, Hu F . Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2017; 14(2):88-98. DOI: 10.1038/nrendo.2017.151. View

16.

Hu C, Jia W . Diabetes in China: Epidemiology and Genetic Risk Factors and Their Clinical Utility in Personalized Medication. Diabetes. 2017; 67(1):3-11. DOI: 10.2337/dbi17-0013. View

17.

Manavalan J, Cremers S, Dempster D, Zhou H, Dworakowski E, Kode A . Circulating osteogenic precursor cells in type 2 diabetes mellitus. J Clin Endocrinol Metab. 2012; 97(9):3240-50. PMC: 3431571. DOI: 10.1210/jc.2012-1546. View

18.

Clement-Lacroix P, Ormandy C, Lepescheux L, Ammann P, Damotte D, Goffin V . Osteoblasts are a new target for prolactin: analysis of bone formation in prolactin receptor knockout mice. Endocrinology. 1999; 140(1):96-105. DOI: 10.1210/endo.140.1.6436. View

19.

Majumdar A, Mangal N . Hyperprolactinemia. J Hum Reprod Sci. 2013; 6(3):168-75. PMC: 3853872. DOI: 10.4103/0974-1208.121400. View

20.

Siris E, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus M . The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int. 2014; 25(5):1439-43. PMC: 3988515. DOI: 10.1007/s00198-014-2655-z. View