ABSTRACT
BACKGROUND: The polyethylene glycol (PEG) precipitation test is widely used to detect hyperprolactinaemia caused by macroprolactin. We report two cases of hyperprolactinaemia in which a low recovery of serum prolactin (PRL) after PEG precipitation indicated the presence of macroprolactin, but no macroprolactin was detected by gel filtration chromatography (GFC). Both cases had elevated concentrations of serum globulin (IgG myeloma and polyclonal hypergammaglobulinaemia due to human immunodeficiency virus [HIV] infection), which prompted us to investigate further the effect of serum globulin on the specificity of the PEG precipitation procedure. METHODS: The effect of increasing concentrations of gamma globulin on the precipitation of PRL by PEG was studied by adding purified human gamma globulin to serum. Ten samples from HIV-infected patients, which showed a low recovery of PRL after PEG precipitation (<60%) were studied with GFC. RESULTS: Addition of gamma globulin decreased the recovery of PRL following precipitation with PEG and gamma globulin concentrations correlated inversely with PRL concentrations (r = 0.9429, P < 0.0167) and percentage recovery of PRL (r = -1.000, P < 0.005). Only one out of 10 samples from HIV-infected patients with PRL recoveries of <60% following PEG precipitation showed a substantial macroprolactin component on GFC. CONCLUSIONS: Monomeric PRL is co-precipitated with serum globulins by PEG. Increased serum globulin concentrations can increase the amount of monomeric PRL precipitated by PEG giving a false estimate of the monomeric PRL and the erroneous impression that macroprolactin is present. The results of the PEG precipitation test should be interpreted with caution in patients with elevated serum globulin concentrations.
Subject(s)
Hyperprolactinemia/diagnosis , Polyethylene Glycols/chemistry , Prolactin/blood , Serum Globulins/metabolism , Adult , Chemical Precipitation , Chromatography, Gel , False Positive Reactions , Female , Humans , Male , Middle Aged , Molecular Diagnostic TechniquesABSTRACT
It has been suggested that changes in fat-free weight may not fully explain the decline of resting metabolic rate (RMR) that occurs with aging. We therefore examined the hypothesis that a reduction in maximal aerobic capacity (VO2max) may partially explain the lower RMR in older men, after accounting for differences in fat-free weight and fat weight. We also considered differences in energy intake and plasma thyroid hormones as possible modulators of the age-related decline in RMR in men. Three-hundred healthy men (aged 17 to 78 years) were characterized for: (1) RMR (kcal/min) from indirect calorimetry; (2) body composition from underwater weighing; (3) maximal aerobic capacity from a test of VO2max; (4) plasma thyroid hormones (total triiodothyronine [T3], free T3, total thyroxine [T4], and free T4); and (5) estimated energy intake (kcal/d) from a 3-day food diary. A curvilinear decline of RMR with age was found (P less than .01), in which no relationship was found in men less than 40 years of age (r = .10, slope = 0.002 kcal/min/yr), whereas in men older than 40 years, RMR was negatively related to age (r = -.52, slope = -0.008 kcal/min/yr). After statistical control for differences in fat-free weight and fat weight, a negative relationship between age and RMR persisted (partial r = -.30, P less than .01). It was only after control for fat-free weight, fat weight, and VO2max (partial r = -.10, P greater than .05) that no association between age and RMR was noted.(ABSTRACT TRUNCATED AT 250 WORDS)
