Analysis of the role of reduced prolactin levels in the occurrence of NAFLD in postmenopausal women hospitalized in the department of endocrinology
Objective To explore the mediating effect of prolactin(PRL)on menopausal status and non-alcoholic fatty liver disease(NAFLD)in women hospitalized in the Department of Endocrinology.Methods According to the inclusion criteria,a total of 2 399 female patients who hospitalized in the Endo-crinology Department of Drum Tower Hospital affiliated to Nanjing University Medical School from April 2016 to February 2022 were retrospectively analyzed.Menopause is defined as 12 months of amenorrhea in women.Patients were classified into premenopausal group(n=705)and postmenopausal group(n=1 694).Abdominal ultrasonography was used to diagnose NAFLD.All patients'fasting blood samples were collected for the HbA1c,blood glucose,blood lipids,liver enzymes,PRL,estradiol,and other sex hormone measurements.Results The prevalence of NAFLD was higher in the postmenopausal group than in the premenopausal group(42.6％vs.29.4％,P＜0.001).Compared with those in the premenopausal group,serum PRL levels of patients were lower in the postmenopausal group[6.8(5.0,9.4)pg/L vs.11.3(8.5,15.8)μg/L,P＜0.001].Multivariate logistic regression analysis indicated that the postmeno-pausal state was a risk factor for NAFLD(OR 2.278,95％CI 1.551-3.347,P＜0.001)and serum PRL level was a protective factor for NAFLD(OR 0.944,95％CI 0.921-0.968,P＜0.001).Mediation analy-sis showed that serum PRL played a partial mediating role between menopausal status and NAFLD in women,with proportion mediated 36.88％.Conclusion Lower serum prolactin is a mediator of the associa-tion between NAFLD and menopausal status in women hospitalized in the Endocrinology Department.
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