The Metabolic Consequences of Hyperprolactinemia

Hyperprolactinemia, defined as persistently elevated serum prolactin levels, is a common endocrine disorder with systemic metabolic consequences that extend beyond its classical roles in lactation and reproductive function. This review summarizes current evidence regarding the interplay between prolactin excess and metabolic regulation. Chronic hyperprolactinemia is associated with increased appetite, weight gain, and elevated BMI, likely mediated through altered dopaminergic tone, leptin resistance, and direct effects on adipose tissue. Dyslipidemia is frequently observed, characterized by elevated total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides, alongside reduced high-density lipoprotein cholesterol (HDL-C). Additionally, prolactin excess contributes to impaired glucose homeostasis, manifesting as increased fasting glucose levels, elevated HbA1c, and insulin resistance. Emerging data also suggest associations with endothelial dysfunction, cardiovascular risk, neuropsychiatric disturbances, and reduced bone mineral density. These findings support the conceptualization of hyperprolactinemia as a multisystem disorder requiring comprehensive clinical evaluation and management. Further studies are needed to elucidate the underlying mechanisms and optimize therapeutic strategies.