Serum prolactin in patients with liver disease in comparison with healthy adults: A preliminary cross-sectional study

INTRODUCTION: Studies from the west have shown raised prolactin levels in patients with liver disease. Considering the lacunae on Indian context, we conducted the present study with an objective to assess the prolactin levels in patients with cirrhosis and viral hepatitis with or without features of encephalopathy. The data presented here are the results of the preliminary analysis. MATERIALS AND METHODS: The present study was a prospective, cohort study among patients diagnosed as either viral hepatitis or cirrhosis liver. A cohort of normal healthy adults was selected based on history and laboratory investigations (complete blood count, liver and renal function tests). Serum prolactin was measured for all the study participants, and Kruskal–Wallis H-test with post-hoc Dunn's test was used to analyze the significance of the differences in the levels between various groups. Tests of diagnostic accuracy were used to assess the prediction capability of serum prolactin with a cut-off level of 50 ng/ml. RESULTS: A total of 70 patients (10 - normal healthy; 25 - acute viral hepatitis; 35 - cirrhosis liver) were recruited in the present study with the median (range) age in years of 56 (34–68) and male: female ratio of 2:1. A statistically significant (P < 0.05) increase in the serum prolactin was observed in patients with cirrhosis with or without encephalopathy. But, among the patients with viral hepatitis, a significant elevation was observed only in patients with encephalopathy. Additionally, a statistically significant association was observed between serum prolactin levels with serum bilirubin (ρ =0.67, P = 0.04) and aspartate aminotransferase (ρ =0.72, P = 0.05). A cut-off value of 50 ng/ml of serum prolactin was found to predict the mortality. A total of 4/12 (33.3%) with prolactin value of <50 ng/ml died while 11/23 (47.8%) died with values >50 ng/ml (P < 0.05). Similarly, in patients with viral hepatitis with encephalopathy features, 1/4 (25%) with prolactin value of <50 ng/ml died while among those without any such features (n = 21), 9 (42.9%) died (P < 0.05). CONCLUSION: Serum prolactin has a significant association with patients with liver disease and predicts mortality.