ergoline and Cardiovascular-Diseases

Dopamine action appears to play a role in changes that are seen in obesity, metabolic syndrome and type 2 diabetes mellitus. Bromocriptine-QR (Quick Release), a dopamine agonist, is approved for use in treatment of type 2 diabetes. It has demonstrated modest improvement in glycemic parameters, cholesterol and weight in certain cohorts. Limited data using cabergoline, a long-acting dopamine agonist, also demonstrate glycemic efficacy. Additionally, bromocriptine-QR appears to have a favorable cardiovascular risk reduction. The direct mechanism by which bromocriptine-QR, or central dopamine agonism, achieves modest glycemic control and favorable cardio-metabolic profile is unclear. This relationship appears to be more complex than the historical explanation of "resetting" the circadian clock and may further be elucidated using data in individuals with hyperprolactinemia and prolactinoma.

Topics: Animals; Biomarkers; Blood Glucose; Bromocriptine; Cabergoline; Cardiovascular Diseases; Comorbidity; Diabetes Mellitus, Type 2; Dopamine Agonists; Ergolines; Humans; Hypoglycemic Agents; Risk Factors; Treatment Outcome

Hyperprolactinaemia is suggested to be associated with metabolic and hormonal complications. No previous study has compared the effect of different dopamine agonists on plasma lipids, carbohydrate metabolism markers and cardiovascular risk factors in patients with elevated prolactin levels. The study included eight bromocriptine-resistant women with prolactinoma (group 1) and twelve matched women with hyperprolactinaemia unrelated to prolactinoma (group 2). Group 1 was then treated with cabergoline, while group 2 with bromocriptine. Plasma lipids, glucose homeostasis markers and plasma levels of prolactin, insulin-like growth factor-1 (IGF-1) and cardiovascular risk factors were assessed before and after 6 months of therapy. Both treatments normalized plasma prolactin levels. Cabergoline reduced triglycerides, 2-hr post-challenge plasma glucose, the homeostatic model assessment of insulin resistance (HOMA-IR), and circulating levels of IGF-1, free fatty acids (FFA), uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine and fibrinogen, as well as increased HDL cholesterol and 25-hydroxyvitamin D. With the exception of a reduction in HOMA-IR, bromocriptine treatment produced no significant effect on the investigated biomarkers. Cabergoline was superior to bromocriptine in affecting 2-hr post-challenge plasma glucose levels, HOMA-IR, as well as circulating levels of IGF-1, FFA, uric acid, hsCRP, homocysteine, fibrinogen and 25-hydroxyvitamin D. Our results may suggest that cabergoline is superior to bromocriptine when it comes to affecting atherogenic dyslipidaemia, insulin sensitivity and circulating levels of cardiovascular risk factors in hyperprolactinaemic patients. These findings seem to support previous observations that cabergoline may be a better treatment for patients with elevated prolactin levels than bromocriptine.

Topics: Adult; Blood Glucose; Bromocriptine; Cabergoline; Cardiovascular Diseases; Dopamine Agonists; Ergolines; Female; Humans; Hyperprolactinemia; Insulin Resistance; Insulin-Like Growth Factor I; Lipids; Middle Aged; Prolactin; Risk Factors

In view of the association of hyperprolactinaemia with insulin resistance, we hypothesized that patients with hyperprolactinaemia may present increased cardiovascular risk markers.. Descriptive clinical trial.. Serum glucose, insulin, insulin resistance, lipids, high sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, tumour necrosis factor (TNF)-alpha and soluble E-selectin (sELAM-1) serum levels were determined in 15 patients with hyperprolactinaemia at baseline (compared with 20 healthy subjects) and after 12 weeks of cabergoline therapy (0.5-1 mg twice per week). We also measured mononuclear cell NF-kappaB activation and TNF-alpha production in a subset of subjects.. Serum levels of prolactin (PRL), insulin, insulin resistance (HOMA-IR) index and hsCRP were significantly higher in patients than in control subjects. Markers of mononuclear cell activation did not differ between the groups. Hyperprolactinaemia, BMI and age were predictors of hsCRP. BMI was the only predictor of HOMA-IR. Cabergoline therapy significantly reduced serum PRL, insulin, hsCRP and sELAM-1 levels.. These data suggest that hyperprolactinaemia is associated with insulin resistance related to increased BMI and low-grade inflammation independently of BMI. Short-term cabergoline therapy can reduce the inflammatory markers.

Topics: Adult; Biomarkers; Blood Glucose; C-Reactive Protein; Cabergoline; Cardiovascular Diseases; E-Selectin; Enzyme-Linked Immunosorbent Assay; Ergolines; Female; Humans; Hyperprolactinemia; Inflammation; Insulin; Insulin Resistance; Interleukin-6; Linear Models; Lipids; Male; Middle Aged; Obesity; Risk Factors; Tumor Necrosis Factor-alpha

A double blind study was carried out comparing 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol-(5-bromonicotinate) (nicergoline, Sermion) and placebo in 60 thromboembolic patients on long-term controlled acenocoumarol treatment. Aim of the trial was to assess the hypothesis of an interaction on both the coagulatory parameters and the clinical findings. No significant variations of the acenocoumarol daily dose were required in nicergoline treated group and no interaction was demonstrated in coagulatory parameters. Prothrombin activity and thrombo-test evaluated fortnightly were not statistically different in nicergoline and placebo groups while the platelet antiaggregating activity of nicergoline was confirmed after a three months' treatment. Bleeding time was unaffected. Minor differences in clinical findings were observed in the two groups.

Topics: Acenocoumarol; Adult; Aged; Cardiovascular Diseases; Clinical Trials as Topic; Double-Blind Method; Drug Interactions; Ergolines; Humans; Middle Aged; Nicergoline; Platelet Aggregation

Topics: Bromocriptine; Cabergoline; Cardiovascular Diseases; Ergolines; Female; France; Hormone Antagonists; Humans; Lactation

Topics: Aged; Antiparkinson Agents; Cabergoline; Cardiovascular Diseases; Dopamine Agonists; Ergolines; Female; Humans; Male; Parkinson Disease; Pergolide; Treatment Outcome

Topics: Cabergoline; Cardiovascular Diseases; Dopamine Agonists; Ergolines; Humans; Hyperprolactinemia; Insulin Resistance; Obesity; Risk Factors

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women in reproductive age. As for the treatment of this disease the lack of a clear etiology for PCOS has led to a symptom-orientated treatment. However, the overall aims of treatment are to induce ovulation for women desiring conception, to reduce androgen levels, to reduce body weight and to reduce long-term health risks of diabetes mellitus and cardiovascular disease. Clomiphene citrate (CC) is recommended as first line treatment for induction of ovulation in patients with PCOS by virtue of its efficacy, safety, and ease of administration. Alternatives for CC-resistant patients include gonadotrophin therapy (better with low-dose step-up protocol) and laparoscopic ovarian diathermy. Recently, recombinant FSH (rFSH) has been introduced in clinical practice and it seems more effective than urinary FSH as demonstrated by a significantly higher number of follicles recruited and embryos obtained with a shorter treatment period. The addition of GnRH-agonist to the stimulation protocol for women affected by PCOS could reduce premature luteinization and increase cycle fecundity. Other drugs under investigation are metformin and cabergoline. Hirsutism is the manifestation of hyperandrogenemia in PCOS. The primary goal of the treatment of hirsutim is central or peripheral androgen suppression using 3 groups of drugs: inhibitors of androgen production (oral contraceptives, GnRH analogues), peripheral androgen blockers (cyproterone acetate, flutamide, finasteride and spironolactone), and insulin-sensitizing agents (metformin). Weight reduction and exercise could also improve not only menstrual disturbances and infertility, but also insulin resistance and its adverse metabolic con-sequences.

Topics: Adult; Androgen Antagonists; Cabergoline; Cardiovascular Diseases; Clomiphene; Cyproterone Acetate; Diabetes Complications; Dopamine Agonists; Ergolines; Female; Finasteride; Flutamide; Follicle Stimulating Hormone; Gonadotropins; Hirsutism; Humans; Hypoglycemic Agents; Infertility, Female; Insulin Resistance; Metformin; Mineralocorticoid Receptor Antagonists; Obesity; Ovulation Induction; Polycystic Ovary Syndrome; Risk Factors; Spironolactone; Weight Loss