PREDICTORS OF CARDIOVASCULAR DISEASE IN YOUNG WOMEN IN EARLY PREMENOPAUSE

Objective: To identify predictors of cardiovascular disease (CVD) in young women in the early premenopause period. Design and method: 66 women were examined. The 1st group (n=26) (44.6±2.6 years) had a pituitary adenoma and received cabergoline therapy for two years to maintain the target prolactin level. In the 2nd group (n=21) (42.8±3.5 years), an adenoma with an elevated prolactin level was detected according to MRI of the pituitary gland, but the patients did not take cabergoline for various reasons. Patients of the 3rd group (n=19) (43.9±3.4 years) with idiopathic hyperprolactinemia also did not receive therapy to suppress prolactin synthesis. The levels of prolactin (Pro), dihydrotestosterone (DTS) androstenedione (ASD), homocysteine, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) were determined. Daily BP monitoring was performed, left ventricular myocardial mass index (LVMI, g/m2),LV relative wall thickness (RWT) indices were determined by echocardiography. Results: The target Pro level in group 1 was normal (286.2±45); in groups 2 and 3 it was high (881.9±79.2; 692.2±63.3, respectively, p<0.01). The concentration of DTS in group 1 was lower than in groups 2 and 3 (367.1 ± 147.1; 611.1 ± 107; 593.1 ± 193.2; p < 0.01). The level of ASD was 8.9 ± 1.3; 20.7 ± 1.3; 19.3 ± 1.3 (p < 0.01). The homocysteine content in group 1 was normal (6.7 ± 1.4); in the 2nd and 3rd - increased (13.7 ± 1.5 and 13.7 ± 0.8; p < 0.01). In group 1, LDL-C was 2.54 ± 0.2; in the 2nd and 3rd – 3.35±0.2 and 3.02±0.2 (p<0.05). The concentration of TG was the lowest in the 1st group (1.81±0.1), in the 2nd and 3rd – 2.17±0.2 and 2.11±0.2 (p<0.05). The frequency of arterial hypertension (AH) in the 1st group was 15.4% with normal LV IMM (73.4±4.4 g/m2); in the 2nd – 38.1% with IMM 86.8±4.2 g/m2 (p<0.01); in the 3rd – 31.6% with IMM 84±4.4 g/m2. The LV TCI was reduced and amounted to 0.41, 0.37 and 0.40. Conclusions: In young women with hyperprolactinemia in the early premenopausal period, regardless of its origin, predictors of the development of CVD are identified.