Impact of Hyperprolactinemia on Hemoglobin and Neutrophil-to-Lymphocyte Ratio: A Cross-Sectional Study in Patients with Prolactinoma

Authors : İsmail Engin
Pages : 68-75
Doi:10.58961/hmj.1748826
View : 61 | Download : 80
Publication Date : 2025-08-29
Article Type : Research Paper
Abstract :Introduction: Hyperprolactinemia is implicated in anemia of chronic disease and low-grade systemic inflammation, yet robust clinical data controlling for confounding factors remain limited. This study examined hematologic parameters in patients with newly-diagnosed prolactinoma after carefully excluding nutritional, hormonal, and organ-related confounders. Materials and Methods: Fifty-eight treatment-naïve patients (13 men, 45 women) with MRI-confirmed prolactinoma and 65 age- and sex-matched healthy controls were enrolled between January 2022 and March 2023. All participants had normal iron studies (ferritin, TSAT), vitamin B12, folate, renal, and hepatic profiles. Testosterone levels were measured in all male participants. Primary outcomes were hemoglobin (Hb) concentration and neutrophil-to-lymphocyte ratio (NLR). Anemia was defined using WHO criteria (Hb <13.0 g/dL in men, <12.0 g/dL in women). Results: Prolactin levels were significantly elevated in patients versus controls (median 87.5 ng/mL [IQR 54.3–156.9] vs 9.8 [7.2–13.5], p < 0.001). Men with prolactinoma demonstrated lower Hb levels compared to male controls (13.9 ± 1.2 g/dL vs 15.2 ± 0.8 g/dL, Cohen\\\'s d = 1.29, p < 0.001) and anemia prevalence of 23.1% versus 0%. Women showed no significant difference in Hb levels (12.8 ± 1.1 vs 12.9 ± 0.9 g/dL, p = 0.63). NLR was significantly elevated in both sexes (2.3 ± 0.9 vs 1.7 ± 0.5, p < 0.001). After multivariable adjustment, prolactin levels correlated negatively with Hb in men (β = -0.51, p = 0.003) and positively with NLR in the overall cohort (β = 0.34, p = 0.002). Conclusion: In the absence of nutritional or organ-related confounders, hyperprolactinemia demonstrates significant associations with reduced hemoglobin levels and increased anemia prevalence in men, while correlating with elevated inflammatory markers (NLR) in both sexes. The sex-specific hemoglobin pattern suggests complex hormonal interactions requiring further longitudinal investigation.
Keywords : prolaktinoma, hiperprolaktinemi, hemoglobin, anemi, nötrofil-lenfosit oranı, enflamasyon

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