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Prevalence of Hyperprolactinemia in Overt and Subclinical Hypothyroidism at a Tertiary Center in Basra, Iraq | ||
| Al- Anbar Medical Journal | ||
| Volume 21, Issue 3, July 2025, Pages 185-190 PDF (471.36 K) | ||
| Document Type: Original articles | ||
| DOI: 10.33091/amj.2025.157917.2138 | ||
| Authors | ||
| Aya A. Al-Rubaye* 1; Nassar T. Alibrahim2 | ||
| 1Department of Family and Community Medicine/Community Medicine, College of Medicine, University of Basrah, Basrah, Iraq. | ||
| 2Faiha Specialized Diabetes, Endocrine and Metabolism Center, Basrah Health Directorate, Basrah, Iraq. | ||
| Abstract | ||
| Background: Hyperprolactinemia is a common condition resulting from excessive prolactin secretion by pituitary lactotrophs. Both overt and subclinical hypothyroidism (ScH) contribute to its development. Objectives: To assess the prevalence of hyperprolactinemia in patients with subclinical and overt hypothyroidism and explore its association with polycystic ovary syndrome (PCOS) and body mass index (BMI). Materials and Methods: This retrospective cross-sectional study included 917 women who underwent thyroid function and serum prolactin testing at Faiha Specialized Diabetes, Endocrine, and Metabolism Center in Basra between 2017 and 2023. Patients were categorized into euthyroid, ScH, and overt hypothyroidism based on thyroid-stimulating hormone (TSH) and free tetra-iodothyronine (FT4) levels. Hyperprolactinemia was defined as serum prolactin ≥ 20 ng/mL. Results: The prevalence of hyperprolactinemia was 24.2%, with higher rates in ScH (36.1%) and overt hypothyroidism (35.9%) compared to the euthyroid group (21.7%). The median TSH levels were significantly higher in overt hypothyroidism than in ScH and euthyroid groups, while FT4 levels were significantly lower in overt hypothyroidism. PCOS was observed in 15.4% of participants, with no significant association with thyroid dysfunction. However, PCOS patients had significantly higher prolactin levels than non-PCOS patients. A moderate positive correlation was observed between TSH and prolactin levels in overt hypothyroidism, while no significant correlation was found in ScH. Conclusions: Prolactin levels were significantly elevated in subclinical and overt hypothyroidism, emphasizing the need for prolactin assessment in these patients. PCOS patients exhibited higher prolactin levels. Future community-based assessments can strengthen these findings. | ||
| Keywords | ||
| Hyperprolactinemia; Hypothyroidism; Pituitary Function; Thyroid Dysfunction; Polycystic Ovary Syndrome | ||
| References | ||
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[1] A. Glezer and M. D. Bronstein. Hyperprolactinemia,” in Endotext [Online], K. R. Feingold, S. F. Ahmed, B. Anawalt, et al., Eds. South Dartmouth (MA): MDText.com, Inc., 2000– [updated Jan. 5, 2022]. Available: https://www.ncbi.nlm.nih.gov/books/NBK278984/."
[2] "A. R. Amberina, A. Jabeen, C. Kumar, T. Ravirala, S. Ch, and A. V. L., “Prevalence of hyperprolactinemia in hypothyroid patients,” MedPulse International Journal of Biochemistry, vol. 16, no. 3, pp. 5–9, Dec. 2020.."
[3] K. Aziz, A. Shahbaz, M. Umair, M. Sharifzadeh, and I. Sachmechi, "Hyperprolactinemia with Galactorrhea Due to Subclinical Hypothyroidism: A Case Report and Review of Literature," (in eng), Cureus, vol. 10, no. 5, p. e2723, May 31 2018, doi: 10.7759/cureus.2723.
[4] T. S. S. Al-Rawi, N. S. Shamkhi, and N. Haddad, "Association of Anti-Thyroglobulin and Anti-Thyroid Peroxidase Antibodies in Patients with Primary Hypothyroidism," (in en), Al- Anbar Medical Journal, vol. 19, no. 2, pp. 141-147, 2023, doi: 10.33091/amj.2023.141014.1201.
[5] "Differentiation Between Clinical and Subclinical Hypothyroidism in Pathophysiology, Symptoms, Diagnosis and Treatment – A Narrative Review," Baghdad Journal of Biochemistry and Applied Biological Sciences, vol. 5, no. 3, pp. 144-161, 09/30 2024, doi: 10.47419/bjbabs.v5i03.285.
[6] A. M. Rababa'h, B. R. Matani, and A. Yehya, "An update of polycystic ovary syndrome: causes and therapeutics options," (in eng), Heliyon, vol. 8, no. 10, p. e11010, Oct 2022, doi: 10.1016/j.heliyon.2022.e11010.
[7] M. Gierach, M. Bruska-Sikorska, M. Rojek, and R. Junik, "Hyperprolactinemia and insulin resistance," (in eng), Endokrynol Pol, vol. 73, no. 6, pp. 959-967, 2022, doi: 10.5603/EP.a2022.0075.
[8] "World Health Organization, “Body mass index,” Global Health Observatory (GHO) data, [Online]. Available: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index. [Accessed: Apr. 21, 2023].".
[9] "American Board of Internal Medicine, Laboratory Reference Ranges. [Online]. Available: https://www.abim.org/Media/bfijryql/laboratory-reference-ranges.pdf. [Accessed: Apr. 19, 2024].".
[10] C. R. W. Edwards, I. A. Forsyth, and G. M. Besser, "Amenorrhoea, galactorrhoea, and primary hypothyroidism with high circulating levels of prolactin," Br Med J, vol. 3, no. 5772, pp. 462-464, 1971.
[11] T. G. Swapnika, S. S. Sabitha Rani, S. Dipankar, A. B. H. Itagi, and I. S. Vamshidhar, "A Comparative Study of Iron Status in Subclinical Hypothyroid and Euthyroid Subjects in a Tertiary Care Hospital," (in eng), Cureus, vol. 16, no. 1, p. e52007, Jan 2024, doi: 10.7759/cureus.52007.
[12] A. Bahar, O. Akha, Z. Kashi, and Z. Vesgari, "Hyperprolactinemia in association with subclinical hypothyroidism," (in eng), Caspian J Intern Med, vol. 2, no. 2, pp. 229-33, Spring 2011.
[13] C. Meier, M. Christ-Crain, M. Guglielmetti, P. Huber, J. J. Staub, and B. Müller, "Prolactin dysregulation in women with subclinical hypothyroidism: effect of levothyroxine replacement therapy," (in eng), Thyroid, vol. 13, no. 10, pp. 979-85, Oct 2003, doi: 10.1089/105072503322511391.
[14] Z. Hekimsoy, S. Kafesçiler, F. Güçlü, and B. Ozmen, "The prevalence of hyperprolactinaemia in overt and subclinical hypothyroidism," (in eng), Endocr J, vol. 57, no. 12, pp. 1011-5, 2010, doi: 10.1507/endocrj.k10e-215.
[15] P. Goel, Kahkasha, S. Narang, B. K. Gupta, and K. Goel, "Evaluation of serum prolactin level in patients of subclinical and overt hypothyroidism," (in eng), J Clin Diagn Res, vol. 9, no. 1, pp. Bc15-7, Jan 2015, doi: 10.7860/jcdr/2015/9982.5443.
[16] V. Wiwanitkit, "Hyperprolactinemia and Hypothyroidism," Medical Journal of Dr. D.Y. Patil University, vol. 12, no. 3, pp. 225-226, 2019, doi: 10.4103/mjdrdypu.mjdrdypu_179_18.
[17] S. Koner, A. Chaudhuri, A. Biswas, D. Adhya, and R. Ray, “A study on thyroid profile and prolactin level in hypothyroid females of a rural population of a developing country,” Med. J. Dr. D.Y. Patil Vidyapeeth, vol. 12, no. 3, pp. 217–224, May–Jun. 2019
[18] D. Sanyal and M. Raychaudhuri, "Hypothyroidism and obesity: An intriguing link," (in eng), Indian J Endocrinol Metab, vol. 20, no. 4, pp. 554-7, Jul-Aug 2016, doi: 10.4103/2230-8210.183454.
[19] B. Biondi, “Subclinical hypothyroidism in patients with obesity and metabolic syndrome: A narrative review,” Nutrients, vol. 16, no. 1, p. 87, 2024.
[20] K. van der Ham, K. J. Stekelenburg, Y. V. Louwers, W. van Dorp, M. W. J. Schreurs, R. van der Wal, et al., “The prevalence of thyroid dysfunction and hyperprolactinemia in women with PCOS,” Front. Endocrinol. (Lausanne), vol. 14, p. 1245106, Oct. 2023
[21] Z. Zhao, Y. Gao, X. Pei, W. Wang, R. Wang, and H. Zhang, “Thyroid function and polycystic ovary syndrome: a Mendelian randomization study,” Front. Endocrinol. (Lausanne), vol. 15, p. 1364157, Mar. 2024.
[22] A. B. Kamrul-Hasan and F. T. Aalpona, “Metabolic association of serum prolactin in polycystic ovary syndrome: a retrospective analysis of 840 patients in Bangladesh,” Endocr. Metab. Sci., vol. 14, p. 100153, 2024.
[23] E. M. Kyritsi et al., "The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome," (in eng), Eur J Clin Invest, vol. 48, no. 7, p. e12961, Jul 2018, doi: 10.1111/eci.12961.
[24] K. Szosland, P. Pawlowicz, and A. Lewiński, "Prolactin secretion in polycystic ovary syndrome (PCOS)," (in eng), Neuro Endocrinol Lett, vol. 36, no. 1, pp. 53-8, 2015.
[25] T. Sirohi and H. Singh, "Estimation of serum prolactin levels and determination of prevalence of hyperprolactinemia in newly diagnosed cases of subclinical hypothyroidism," (in eng), J Family Med Prim Care, vol. 7, no. 6, pp. 1279-1282, Nov-Dec 2018, doi: 10.4103/jfmpc.jfmpc_155_18.
[26] D. D. Ramadras, N. A. A. Che Soh Yusof, N. M. Yaacob, W. A. Wan Norlina, and A. H. Hanisah, "Correlation of Serum Prolactin and Thyroid Stimulating Hormone Concentration in Infertile Women: A Systematic Review and Meta-Analysis," (in eng), Malays J Med Sci, vol. 31, no. 1, pp. 14-32, Feb 2024, doi: 10.21315/mjms2024.31.1.2.
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