A number of studies have reported that body weight is higher among patients with prolactinoma than in those with other pituitary tumours.1,2,3 Subsequent weight loss after treatment with dopamine agonists has also been reported,3,4 although this has been disputed in one study that showed weight gain after treatment.5 We therefore undertook a retrospective study of 37 patients with prolactinoma (22 macroprolactinoma and 15 with microprolactinoma, defined by MRI scan of tumour size) and related body weight changes over 24 months to changes in serum and prolactin concentrations.
All patients received dopamine agonists; in addition nine patients with macroadenoma had surgical treatment and four were given radiotherapy. Pituitary function was otherwise normal in all patients with microadenoma; 14 patients with macroadenoma had growth hormone deficiency, nine of whom were given growth hormone replacement, 14 patients were on thyroxine, 11 were on hydrocortisone and 11 on sex hormone replacement. Although the initial body weight with macroprolactinoma was higher than in microprolactinoma, it should be noted that more than half of these subjects were males, and that they were on average older than those with microadenomas. Only two patients complained of recent weight gain at the initial consultation. Despite significant decreases in serum prolactin concentration after treatment, there were no changes in body weight after 2 y in either group of patients (Table 1). Weight fluctuations after treatment in individual patients were not related to the serum prolactin concentration, or the treatment given; most patients remained weight stable, and only four patients lost more than 2 kg in weight. These data suggest that there is no relationship between circulating prolactin concentration and changes in body weight after treatment in patients with prolactinoma and do not support the contention that hyperprolactinaemia is a reversible cause of weight gain.
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Soran, H., Wilding, J. & MacFarlane, I. Body weight and prolactinoma: a retrospective study. Int J Obes 28, 183 (2004). https://doi.org/10.1038/sj.ijo.0802492
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