Impact of Gender on the Association between Low Serum Prolactin and Left Ventricular Mass in Subjects with Prediabetes

BACKGROUND: Low circulating prolactin hormone was associated with increased risk for type 2 diabetes mellitus. An inverse association of serum prolactin with cardiac remodeling was also previously suggested. Thus, the first question arises whether low serum prolactin is associated with adverse cardiac remodeling in subjects with prediabetes and if so what the impact of gender is? Second, could serum prolactin be considered a predictor of cardiac morbidity in those subjects? This study was conducted to assess prolactin level variations in relation to echocardiographic indices of cardiac remodeling among adult men and women with prediabetes. METHODS: This cross sectional study enrolled 80 subjects with prediabetic; 40 men and 40 women. Anthropometric measurements, plasma glucose, lipid profile, homeostasis model assessment of insulin resistance, white blood cells count, prolactin and echocardiography were assessed. RESULTS: Prolactin was significantly lower in men than in women with prediabetes. Left ventricular mass (LVM) was significantly higher in men than in women with prediabetes. The proportion of left ventricular hypertrophy (LVH) in men with prediabetes was 45% compared with 22.5% in women (P=0.03). We also found inverse independent associations of serum prolactin with LVM and LVH in men, but not in women. CONCLUSION: In prediabetes, physiologically low serum prolactin is an independent predictor of increased LVM and LVH in adult men, but not in women. Prolactin may be a potential diagnostic biomarker for cardiac remodeling in adult men with prediabetes.

Relation of vascular endothelial growth factor [VEGF] to diabetic nephropathy in type 2 diabetic patients

Diabetic nephropathy in type 2 DM is a frequent complication associated with increased morbidity and mortality. The aim of this work is to evaluate the relation of vascular endothelial growth factor to diabetic nephropathy in type 2 diabetic patients and to assess whether its levels is related to the severity of diabetic nephropathy. This study included 38 type 2 diabetic patients grouped into nephropathic and non-nephropathic groups based on urinary albumin excretion [UAE], nephropathic group was further grouped into microalbuminuric and macroalbuminuric subgroups according to the level of UAE. In addition 10 healthy subjects of matched age, sex and body mass index [BMI] served as a control group. All participants underwent clinical examination, laboratory investigations; traditional investigations. UAE and serum and urinary vascular endothelial growth factor [VEGF]. The nephropathic group was of longer duration, had poor glycemic control compared to the non-nephropathic group. Serum and urinary VEGF levels were elevated in all diabetic patients compared to controls and in the nephropathic group versus the non-nephropathic. The elevation was significantly higher in macroalbuminuric group compared to the microalbuminuric group. Furthermore, serum and urine VEGF levels showed a significant positive correlation with serum creatinine and UAE. The hyperglycemic milieu in type 2 diabetes may induce VEGF overproduction that paves the way for diabetic renal insult and hence diabetic nephropathy