Macroprolactinaemia: prevalence and aetiologies in a large group of hospital workers
Macroprolactinaemia: prevalence and aetiologies in a large group of hospital workers
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DOI：
10.1111/j.1365-2265.2009.03570.x
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发表时间：
2009-11-01
影响因子：
3.2
通讯作者：
Saiki, Yasuhiko
中科院分区：
文献类型：
--
作者：
Hattori, Naoki;Ishihara, Takashi;Saiki, Yasuhiko
巨泌乳素血症是高泌乳素血症的原因之一，常导致误诊和治疗不当，但病因尚不清楚。本研究的目的是确定健康人群中巨泌乳素血症的患病率，并研究巨泌乳素的发病机制。在日本的一家医院进行B型肝炎病毒筛查试验后，使用过量血清进行疾病的机制和诊断。采用聚乙二醇（PEG）沉淀法筛选巨泌乳素血症患者。血清中含有macroprolactin进一步检查可能的caetiologs.ResultsOf 1330例，49（3个中心点68%）被诊断为macroprolactin血症的结合研究。大量泌乳素血症受试者未经治疗的样本中高泌乳素血症的频率（30个中心点6%）显著高于无大量泌乳素血症的个体（2个中心点26%）。在49例巨泌乳素血症受试者中，PEG清除巨泌乳素后，所有受试者的单体PRL浓度均正常。在发现的44例高泌乳素血症中，15例（34个中心点1%）有巨泌乳素血症。IgG结合的催乳素中检测到的所有血清含有macroprolactin。IgG结合催乳素的水平与巨催乳素的水平呈正相关，表明IgG结合催乳素形成巨催乳素。大约四分之三的巨泌乳素血症受试者有抗催乳素自身抗体。糖基化，聚集和共价/非共价结合也参与了macroprolactin.ConclusionsMacroprolactinaemia的形成是一种常见的疾病，并导致高催乳素血症在健康人群中。我们的受试者中巨催乳素的主要病因是催乳素-IgG复合物，主要包括抗催乳素自身抗体和其他次要的催乳素复合物。
P>ObjectiveMacroprolactinaemia is one of the causes of hyperprolactinaemia and often leads to misdiagnosis and inappropriate treatment, but the aetiologies are unclear. The objective of the study was to determine the prevalence of macroprolactinaemia in a healthy population and to investigate the mechanisms underlying the development of macroprolactin.DesignObservational study of the prevalence, causes, mechanisms and diagnosis of disease using excess sera after hepatitis B virus screening tests at a hospital in Japan.ParticipantsA total of 1330 hospital workers (1010 women and 320 men) participated in this study.MeasurementsMacroprolactinaemia was screened using the polyethylene glycol (PEG) precipitation method. Sera containing macroprolactin were further examined by binding studies for possible aetiologies.ResultsOf the 1330 subjects, 49 (3 center dot 68%) were diagnosed with macroprolactinaemia. The frequency of hyperprolactinaemia in untreated samples in subjects with macroprolactinaemia (30 center dot 6%) was significantly higher than in individuals without macroprolactinaemia (2 center dot 26%). Of the 49 subjects with macroprolactinaemia, all had a normal monomeric PRL concentration following PEG removal of macroprolactin. Of 44 hyperprolactinaemias found, 15 (34 center dot 1%) had macroprolactinaemia. IgG-bound prolactin was detected in all sera containing macroprolactin. The levels of IgG-bound prolactin positively correlated with those of macroprolactin, suggesting that IgG-bound prolactin forms macroprolactin. Approximately three quarters of the subjects with macroprolactinaemia had anti-prolactin autoantibodies. Glycosylation, aggregation and covalent/noncovalent binding were also involved in the formation of macroprolactin.ConclusionsMacroprolactinaemia is a common disorder and causes hyperprolactinaemia in a healthy population. The major aetiology of macroprolactin in our subjects was complexes of prolactin-IgG comprising mainly anti-prolactin autoantibodies, and other minor complex prolactin species.