SAT-073 Exploring Metabolic Changes With Cabergoline Therapy In Prolactinoma: A Retrospective Analysis

Abstract Disclosure: A. Pekmezci: None. M.M. Delice: None. S. Burhan: None. E. Cetin: None. M. Niyazoglu: None. E. Hatipoglu: None. Background and Objective: Hyperprolactinemia is increasingly recognized as a contributor to adverse metabolic outcomes, including weight gain, insulin resistance, and dyslipidemia. While dopamine agonist therapy—particularly cabergoline—effectively normalizes prolactin levels and reduces tumor size, its metabolic effects remain incompletely understood. This study aimed to evaluate early metabolic changes following cabergoline therapy in patients with prolactinoma and to explore the relationship between PRL reduction and metabolic parameters. Methods: This retrospective study included 101 prolactinoma patients treated with cabergoline at a tertiary center between 2020 and 2023. Clinical, biochemical, and radiological data were evaluated before treatment and at the point of prolactin normalization. Metabolic parameters assessed included body weight, body mass index, fasting glucose, insulin levels, insulin resistance (HOMA-IR), low-density and high-density lipoprotein cholesterol, and triglycerides. Associations between prolactin levels, cabergoline dose, and metabolic outcomes were analyzed. Results: In the overall cohort, the median time to achieve prolactin normalization was 6 [IQR: 3.5–9] months. The median cumulative cabergoline dose was 12 [IQR: 8–22] mg. At baseline, prolactin levels were positively correlated with body weight (r=0.20, p=0.035). Cabergoline treatment led to significant reductions in body weight (p=0.006), body mass index (p=0.008), low-density lipoprotein cholesterol (p<0.001), and triglyceride levels (p=0.004). No significant changes were observed in fasting glucose, insulin, or insulin resistance. However, reductions in prolactin levels were positively correlated with improvements in these glycemic parameters. No associations were found between cumulative cabergoline dose and metabolic outcomes. Improvement in hypogonadism was observed in both sexes but was not significantly related to metabolic changes. Conclusion: Higher baseline prolactin levels were associated with increased body weight and body mass index. Cabergoline therapy led to tumor shrinkage and reduction of the direct hormonal effects of hyperprolactinemia. Treatment was associated with significant decreases in weight, body mass index, triglycerides, and low-density lipoprotein cholesterol. These findings suggest that cabergoline improves body composition and corrects dyslipidemia in parallel with serum prolactin reduction. Importantly, these metabolic improvements occurred independently of cabergoline dose and the presence or resolution of hypogonadism. While tumor regression and hormonal normalization occurred relatively early, metabolic responses appeared to require more time. These findings underscore the importance of continued metabolic monitoring, even after achieving biochemical and radiological remission. Presentation: Saturday, July 12, 2025