Hyperprolactinemia Potentially Linked to Insulin Resistance and Metabolic Dysfunction in PCOS: Study

A new study published in the International Journal of Molecular Sciences showed that hyperprolactinemia may act as a pathophysiological link between obesity, insulin resistance, and impaired carbohydrate metabolism in PCOS patients. Elevated prolactin levels could serve as an additional marker of insulin resistance and potentially worsen it in affected women.

According to the diagnostic criteria used, the prevalence of polycystic ovarian syndrome (PCOS), the most prevalent endocrine condition among women of reproductive age, ranges from 5 to 20%. When two of the three criteria 9chronic anovulation, clinical or laboratory hyperandrogenism, and the existence of polycystic ovaries) are met, PCOS is diagnosed.

Moderate to severe insulin resistance is a hallmark of polycystic ovarian syndrome. In women with PCOS, obesity significantly alters the clinical and laboratory profile. Obesity increases the risk of overt diabetes mellitus in addition to decreasing fertility and worsening insulin resistance.

The prevalence of hyperprolactinemia in women with PCOS described in the literature varies greatly, ranging from less than 5% to more than 65%, due to the many variables that impact both PCOS and hyperprolactinemia. Due to prolactin's lipogenic properties and impact on the metabolic profile, hyperprolactinemia in PCOS patients may further worsen the loss in insulin sensitivity. Thus, this study by Vesselina Yanachkova and team looked into the prolactin levels in the blood of women with PCOS and how they relate to prediabetes, obesity, and insulin resistance.

The computerized database of 157 women with PCOS diagnoses was used in a retrospective monocentric analysis. After OGTT, measurements were made of serum prolactin, BMI, the full glucose-insulin profile, and insulin resistance indicators. The BMI (p = 0.007), fasting glucose (p = 0.003), insulin levels (p < 0.001), and HOMA-IR (p < 0.001) of the women with hyperprolactinemia (40.8%) were all considerably higher.

Prolactin levels were considerably greater in PCOS women who were classified as overweight/obese (47.1%), insulin resistant (68.8%), having impaired fasting glycemia (28.7%), and prediabetic (36.3%) than in their respective counterparts. Therefore, among women with PCOS, greater prolactin levels were substantially linked to an increased risk of developing overweight/obesity, insulin resistance, and prediabetes.

Overall, the findings suggest that hyperprolactinemia may be a pathophysiological connection between PCOS patients' obesity, insulin resistance, and abnormalities in their carbohydrate metabolism. In women with polycystic ovary syndrome, elevated prolactin levels might be an additional indicator of insulin resistance.

Source:

Yanachkova, V., & Stankova, T. (2025). Abnormally increased prolactin levels in women with polycystic ovarian syndrome are associated with risk of obesity, insulin resistance and prediabetes. International Journal of Molecular Sciences, 26(9). https://doi.org/10.3390/ijms26094239