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Diabetologia. 2018 Dec;61(12):2549-2560. doi: 10.1007/s00125-018-4733-9. Epub 2018 Oct 11.

Circulating prolactin concentrations and risk of type 2 diabetes in US women.

Author information

1
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
2
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
3
Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
4
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
5
Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA.
6
Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA.
7
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Shelley.Tworoger@moffitt.org.
8
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Shelley.Tworoger@moffitt.org.
9
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Inc., 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9497, USA. Shelley.Tworoger@moffitt.org.

Abstract

AIMS/HYPOTHESIS:

Prolactin, a multifunctional hormone, is involved in regulating insulin sensitivity and glucose homeostasis in experimental studies. However, whether circulating concentrations of prolactin are associated with risk of type 2 diabetes remains uncertain.

METHODS:

We analysed the prospective relationship between circulating prolactin concentrations and type 2 diabetes risk in the Nurses' Health Study (NHS) and NHSII with up to 22 years of follow-up. Total plasma prolactin was measured using immunoassay in 8615 women free of type 2 diabetes and cardiovascular disease at baseline blood collection (NHS 1989-1990; NHSII 1996-1999) and a subset of 998 NHS women providing a second blood sample during 2000-2002. Baseline bioactive prolactin was measured in a subset of 2478 women using the Nb2 bioassay. HRs were estimated using Cox regression.

RESULTS:

A total of 699 incident type 2 diabetes cases were documented during 156,140 person-years of follow-up. Total plasma prolactin levels were inversely associated with type 2 diabetes risk; the multivariable HR comparing the highest with the lowest quartile was 0.73 (95% CI 0.55, 0.95; ptrend = 0.02). The associations were similar by menopausal status and other risk factors (pinteraction > 0.70). Additional adjustment for sex and growth hormones, adiponectin, and inflammatory and insulin markers did not significantly alter the results. The association of plasma bioactive prolactin with type 2 diabetes risk was non-significantly stronger than that of total prolactin (HR comparing extreme quartiles, 0.53 vs 0.81 among the subset of 2478 women, pdifference = 0.11). The inverse association of total prolactin with type 2 diabetes was significant during the first 9 years after blood draw but waned linearly with time, whereas for bioactive prolactin, the inverse relationship persisted for a longer follow-up time after blood draw.

CONCLUSIONS/INTERPRETATION:

A normally high circulating total prolactin concentration was associated with a lower type 2 diabetes risk within 9-10 years of follow-up since blood draw in US women. Our findings are consistent with experimental evidence, suggesting that among healthy women, prolactin within the biologically normal range may play a protective role in the pathogenesis of type 2 diabetes.

KEYWORDS:

Hormone; Insulin; Prolactin; Type 2 diabetes

PMID:
30306190
PMCID:
PMC6309828
[Available on 2019-12-01]
DOI:
10.1007/s00125-018-4733-9
[Indexed for MEDLINE]

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