切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2026, Vol. 20 ›› Issue (03) : 239 -243. doi: 10.3877/cma.j.issn.1674-0785.2026.03.011

综述

催乳素水平与糖脂代谢
宋子凝, 罗信芝, 薛萌()   
  1. 518020 深圳,暨南大学第二临床医学院 深圳市人民医院内分泌科
  • 收稿日期:2026-03-20 出版日期:2026-03-30
  • 通信作者: 薛萌
  • 基金资助:
    深圳市自然科学基金项目(JCYJ 20250604142222029)

Prolactin levels and glucose-lipid metabolic regulation

Zining Song, Xinzhi Luo, Meng Xue()   

  1. Department of Endocrinology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen 518020, China
  • Received:2026-03-20 Published:2026-03-30
  • Corresponding author: Meng Xue
引用本文:

宋子凝, 罗信芝, 薛萌. 催乳素水平与糖脂代谢[J/OL]. 中华临床医师杂志(电子版), 2026, 20(03): 239-243.

Zining Song, Xinzhi Luo, Meng Xue. Prolactin levels and glucose-lipid metabolic regulation[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2026, 20(03): 239-243.

血清催乳素(PRL)水平异常既可表现为高催乳素血症(HPRL),也可表现为低催乳素血症,均可破坏糖脂代谢稳态。病理性高PRL(>100 μg/L)可导致胰岛素抵抗、葡萄糖耐量下降、血脂异常及动脉粥样硬化风险增加;低血清PRL水平则与胰岛β细胞功能受损、2型糖尿病、内脏肥胖和非酒精性脂肪性肝病相关;稳态功能性短暂性催乳素升高(HomeoFIT‐PRL)对代谢具有保护作用,可改善胰岛素敏感性和血糖控制。临床上应重视血清PRL水平监测,并为患者制定个体化干预策略。

Abnormal serum prolactin (PRL) levels, manifesting as either hyperprolactinemia (HPRL) or hypoprolactinemia, can disrupt glucose and lipid metabolic homeostasis. Pathological hyperprolactinemia (PRL>100 μg/L) may lead to insulin resistance, impaired glucose tolerance, dyslipidemia, and an increased risk of atherosclerosis. In contrast, low serum PRL levels are associated with impaired pancreatic β-cell function, type 2 diabetes mellitus, visceral obesity, and nonalcoholic fatty liver disease. Transient hyperprolactinemia characterized by homeostatic functional increases (Homeostatic Functionally Increased Transient Prolactinemia, HomeoFIT-PRL) exerts protective metabolic effects and may enhance insulin sensitivity and glycemic control. Clinically, serum PRL levels should be closely monitored, and individualized intervention strategies should be developed for affected patients.

1
Fitzgerald P, Dinan TG. Prolactin and dopamine: What is the connection? A review article [J]. J Psychopharmacol, 2008, 22(2 Suppl): 12-19.
2
Marano RJ, Ben-Jonathan N. Minireview: extrapituitary prolactin: an update on the distribution, regulation, and functions [J]. Mol Endocrinol, 2014, 28(5): 622-633.
3
Bernard V, Young J, Binart N. Prolactin - a pleiotropic factor in health and disease [J]. Nat Rev Endocrinol, 2019, 15(6): 356-365.
4
Ghoreshi ZA, Akbari H, Sharif-Zak M, et al. Recent findings on hyperprolactinemia and its pathological implications: A literature review [J]. J Investig Med, 2022, 70(7): 1443-1451.
5
Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: An endocrine society clinical practice guideline [J]. J Clin Endocrinol Metab, 2011, 96(2): 273-288.
6
中华医学会神经外科学分会, 中华医学会妇产科学分会, 中华医学会内分泌学分会. 高催乳素血症诊疗共识 [J]. 中华医学杂志, 2011, 91(3): 147-154.
7
Petersenn S, Fleseriu M, Casanueva FF, et al. Diagnosis and management of prolactin-secreting pituitary adenomas: A pituitary society international consensus statement [J]. Nat Rev Endocrinol, 2023, 19(12): 722-740.
8
Macotela Y, Triebel J, Clapp C. Time for a new perspective on prolactin in metabolism [J]. Trends Endocrinol Metab, 2020, 31(4): 276-286.
9
Pirchio R, Graziadio C, Colao A, et al. Metabolic effects of prolactin [J]. Front Endocrinol(Lausanne), 2022, 13: 1015520.
10
Macotela Y, Ruiz-Herrera X, Vázquez-Carrillo DI, et al. The beneficial metabolic actions of prolactin [J]. Front Endocrinol (Lausanne), 2022, 13: 1001703.
11
Karaca Z, Unluhizarci K, Kelestimur F. Hypoprolactinemia. Does it matter? Redefining the hypopituitarism and return from a mumpsimus : “absence of proof is not the proof of absence” [J]. Rev Endocr Metab Disord, 2024, 25(6): 943-951.
12
Terra LF, Garay-Malpartida MH, Wailemann RA, et al. Recombinant human prolactin promotes human beta cell survival via inhibition of extrinsic and intrinsic apoptosis pathways [J]. Diabetologia, 2011, 54(6): 1388-1397.
13
Chien HY, Chen SM, Li WC. Dopamine receptor agonists mechanism of actions on glucose lowering and their connections with prolactin actions [J]. Front Clin Diabetes Healthc, 2023, 4: 935872.
14
Auriemma RS, De Alcubierre D, Pirchio R, et al. Glucose abnormalities associated to prolactin secreting pituitary adenomas [J]. Front Endocrinol (Lausanne), 2019 10: 327.
15
Pirchio R, Auriemma RS, Solari D, et al. Effects of pituitary surgery and high-dose cabergoline therapy on metabolic profile in patients with prolactinoma resistant to conventional cabergoline treatment [J]. Front Endocrinol (Lausanne), 2021, 12: 769744.
16
Jiang XB, Li CL, He DS, et al. Increased carotid intima media thickness is associated with prolactin levels in subjects with untreated prolactinoma: A pilot study [J]. Pituitary, 2014, 17(3): 232-239.
17
Tuzcu A, Yalaki S, Arikan S, et al. Evaluation of insulin sensitivity in hyperprolactinemic subjects by euglycemic hyperinsulinemic clamp technique [J]. Pituitary, 2009, 12(4): 330-334.
18
Ponce AJ, Galván-Salas T, Lerma-Alvarado RM, et al. Low prolactin levels are associated with visceral adipocyte hypertrophy and insulin resistance in humans [J]. Endocrine, 2020, 67(2): 331-343.
19
Li J, Rice MS, Huang T, et al. Circulating prolactin concentrations and risk of type 2 diabetes in US women [J]. Diabetologia, 2018, 61(12): 2549-2560.
20
Faria de Castro L, Alves Dos Santos Á, Augusto Casulari L, et al. Association between variations of physiological prolactin serum levels and the risk of type 2 diabetes: A systematic review and meta-analysis [J]. Diabetes Res Clin Pract, 2020, 166: 108247.
21
Wang T, Lu J, Xu Y, et al. Circulating prolactin associates with diabetes and impaired glucose regulation: A population-based study [J]. Diabetes Care, 2013, 36(7): 1974-1980.
22
Park S, Kim DS, Daily JW, et al. Serum prolactin concentrations determine whether they improve or impair β-cell function and insulin sensitivity in diabetic rats [J]. Diabetes Metab Res Rev, 2011, 27(6): 564-574.
23
Bole-Feysot C, Goffin V, Edery M, et al. Prolactin(PRL)and its receptor: Actions, signal transduction pathways and phenotypes observed in PRL receptor knockout mice [J]. Endocrine Reviews, 1998, 19(3): 225-268.
24
Freemark M, Avril I, Fleenor D, et al. Targeted deletion of the PRL receptor: Effects on islet development, insulin production, and glucose tolerance [J]. Endocrinology, 2002, 143(4): 1378-1385.
25
Balbach L, Wallaschofski H, Völzke H, et al. Serum prolactin concentrations as risk factor of metabolic syndrome or type 2 diabetes? [J]. BMC endocrine disorders, 2013, 13: 12.
26
Daimon M, Kamba A, Murakami H, et al. Association between serum prolactin levels and insulin resistance in non-diabetic men [J]. PloS One, 2017, 12(4): e0175204.
27
Sheoran A, Agarwal N, Mahto SK, et al. Study of association of serum prolactin levels with insulin resistance in type 2 diabetes mellitus patients [J]. Indian J Endocrinol Metab, 2023, 27(4): 351-356.
28
Lopez-Vicchi F, De Winne C, Brie B, et al. Metabolic functions of prolactin: Physiological and pathological aspects [J]. J Neuroendocrinol, 2020, 32(11): e12888.
29
Brandebourg TD, Bown JL, Ben-Jonathan N. Prolactin upregulates its receptors and inhibits lipolysis and leptin release in male rat adipose tissue [J]. Biochem Biophys Res Commun, 2007, 357(2): 408-413.
30
Lopez-Vicchi F, De Winne C, Ornstein AM, et al. Severe hyperprolactinemia promotes brown adipose tissue whitening and aggravates high fat diet induced metabolic imbalance [J]. Front Endocrinol (Lausanne), 2022, 13: 883092.
31
Posawetz AS, Trummer C, Pandis M, et al. Adverse body composition and lipid parameters in patients with prolactinoma: a case-control study [J]. BMC Endocr Disord, 2021, 21(1): 81.
32
Baba MS, Laway BA, Misgar RA, et al. Metabolic abnormalities, inflammatory markers and endothelial dysfunction in hyperprolactinemia due to prolactinoma before and after normalization of serum prolactin: A prospective case control study [J]. Indian J Endocrinol Metab, 2023, 27(4): 357-364.
33
Ruiz-Herrera X, de Los Ríos EA, Díaz JM, et al. Prolactin promotes adipose tissue fitness and insulin sensitivity in obese males [J]. Endocrinology, 2017, 158(1): 56-68.
34
Liu J, Wang Q, Zhang L, et al. Increased prolactin is an adaptive response to protect against metabolic disorders in obesity [J]. Endocr Pract, 2021, 27(7): 728-735.
35
Liu J, Zhang L, Fu J, et al. Circulating prolactin level is increased in metabolically healthy obesity [J]. Endocrine Connections, 2021, 10(4): 484-491.
36
Zhang P, Ge Z, Wang H, et al. Prolactin improves hepatic steatosis via CD36 pathway [J]. J Hepatol, 2018, 68(6): 1247-1255.
[1] 熊白玉, 朱玮, 区栋财, 刘楚天. 利培酮致非哺乳期乳腺炎一例报道并文献复习[J/OL]. 中华乳腺病杂志(电子版), 2020, 14(02): 129-130.
[2] 向韵, 卢游, 杨凡. 全氟及多氟烷基化合物暴露与儿童肥胖症相关性研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 569-574.
[3] 李英纳, 李敏, 周澳洋, 李平, 杨凡. 肥胖症儿童血浆脑源性神经营养因子水平及其代谢异常的相关性研究[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(01): 81-88.
[4] 蒋冉, 邹彩艳, 桑谊荃. 宫颈上皮内瘤变Ⅲ患者血清性激素水平及其与高危型人乳头瘤病毒感染的关系[J/OL]. 中华妇幼临床医学杂志(电子版), 2023, 19(06): 683-688.
[5] 冉晨曦, 沈如飞, 廖明钰, 廖倩, 周玲, 张玉玲, 隆敏. 垂体瘤孕妇的诊治与围分娩期管理[J/OL]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 487-491.
[6] 张佳妮, 毛赤慧, 曹祺, 王晓东. 妊娠期糖尿病患者产后糖代谢异常转归影响因素分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2022, 18(01): 53-60.
[7] 张薇, 薛慧, 李光明, 王新. 妊娠期糖尿病患者产后血清白细胞介素-34水平对其糖代谢异常转归及胰岛素抵抗恢复的影响[J/OL]. 中华妇幼临床医学杂志(电子版), 2021, 17(05): 606-611.
[8] 高迎春, 潘长清, 张耀. 输卵管通液术联合溴隐亭治疗高催乳素血症所致不孕症合并输卵管阻塞疗效及其对患者血清促黄体激素、抗顶体蛋白酶抗体的影响[J/OL]. 中华妇幼临床医学杂志(电子版), 2020, 16(04): 444-450.
[9] 孙勇, 彭曦. 重视烧伤创面愈合中的葡萄糖代谢以优化营养治疗策略[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(04): 277-281.
[10] 童焕军, 汤朝晖, 全志伟. 肝内胆管癌异常脂质代谢研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2020, 09(06): 501-506.
[11] 苏振宏, 黄玉迪, 解举民. 施奈德结晶状角膜营养不良致病基因功能的研究进展[J/OL]. 中华眼科医学杂志(电子版), 2021, 11(05): 296-300.
[12] 邹创欢, 金法, 龙定超. 闭合性颅脑损伤患者脑脊液氧化脂质代谢物的特征及临床意义[J/OL]. 中华脑科疾病与康复杂志(电子版), 2019, 09(04): 201-204.
[13] 倪玮峰, 田文扬, 倪雨玲, 杨海宁, 施岳柱. 脂质代谢在七氟烷与丙泊酚麻醉对老年结直肠癌患者认知功能中的作用[J/OL]. 中华消化病与影像杂志(电子版), 2026, 16(02): 173-178.
[14] 周杨, 吕淑兰. 围孕期高催乳素血症的诊治与管理[J/OL]. 中华产科急救电子杂志, 2024, 13(01): 24-28.
[15] 任重, 罗濛源, 闫泽晖. 基于生物信息学探讨高脂饮食诱导肥胖与脂质代谢基因表达的转录组研究[J/OL]. 中华肥胖与代谢病电子杂志, 2025, 11(02): 104-110.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?