{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:26:55Z","timestamp":1787160415719,"version":"build-2736575974"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Community Medicine Research Network"},{"name":"University Medicine Greifswald"},{"name":"German Federal State of Mecklenburg- West Pomerania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An evidence-based definition for the lower reference limit of serum prolactin (PRL) is lacking. We recently examined the European Male Ageing Study (EMAS) data and derive a threshold set at 3.0\u2005ng\/mL for hypoprolactinemia in men. Here, we identified the lower reference limit for PRL in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from the Study of Health of Pomerania (SHIP-START, Germany, discovery cohort), and the Women's Health Study (WENDY, Finland, validation cohort). The two-sigma empirical rule was applied to obtain a threshold at 2.5% of the log10 PRL distribution. Logistic and Cox regressions were used to examine the association between PRL and cardiometabolic outcomes at baseline and follow-up, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 2048 women aged 20-81\u2005year from SHIP-START and 1730 women aged 33-37\u2005year from WENDY. The low serum PRL threshold was derived at 2.60 ng\/mL for premenopausal women and 2.29\u2005ng\/mL in women of all ages from SHIP-START, and 4.84\u2005ng\/mL in WENDY. These thresholds were not far off from that previously identified in men (3\u2005ng\/mL). In SHIP-START, we further found that compared to PRL levels of 5.0-34.9\u2005ng\/mL, lower PRL level were more commonly associated with type-2 diabetes and metabolic syndrome at baseline. Moreover, after a median of 12\u2005year of follow-up (IQR = 6.9-15.8\u2005year), the risk of developing myocardial infarction was greater in women with PRL &amp;lt; 2.30\u2005ng\/mL (SHIP-START criteria): adjusted hazard ratio = 4.19 (95% CI: 1.74-10.12), and in women with PRL &amp;lt; 3\u2005ng\/mL (EMAS criteria): hazard ratio = 2.74 (95% CI: 1.44-5.21).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data suggests that a serum PRL level lower than 3\u2005ng\/mL could be adopted for identifying PRL-associated cardiometabolic disease in both sexes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf101","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T07:39:31Z","timestamp":1747035571000},"page":"662-670","source":"Crossref","is-referenced-by-count":6,"title":["The relationship between hypoprolactinemia and cardiometabolic health in women"],"prefix":"10.1093","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-0938","authenticated-orcid":false,"given":"Thang S","family":"Han","sequence":"first","affiliation":[{"name":"Institute of Cardiovascular Research, Royal Holloway University of London , Egham, TW20 0EX ,","place":["United Kingdom"]},{"name":"Department of Endocrinology, Ashford and St Peter's NHS Foundation Trust , Chertsey, GU9 0PZ ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Hannemann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald , 17475 Greifswald ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine , 17475 Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3277-9293","authenticated-orcid":false,"given":"Riikka","family":"Arffman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital , Oulu 90029 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald , 17475 Greifswald ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine , 17475 Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-7353","authenticated-orcid":false,"given":"Till","family":"Ittermann","sequence":"additional","affiliation":[{"name":"Institute for Community Medicine, University Medicine Greifswald , 17475 Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Wilkening","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , 553 St Kilda Road, Melbourne VIC 3004 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9921-7300","authenticated-orcid":false,"given":"Terhi","family":"Piltonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital , Oulu 90029 ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Henry","family":"Fry","sequence":"additional","affiliation":[{"name":"School of Physiology, Pharmacology and Neuroscience, University of Bristol , Bristol BS8 1TD ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4392-0301","authenticated-orcid":false,"given":"Ana B","family":"Crujeiras","sequence":"additional","affiliation":[{"name":"Department of Medicine, CIBER de Fisiopatolog\u00eda Obesidad y Nutricion, Instituto Salud Carlos III, CB06\/03, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (IDIS) , Santiago de Compostela 15706 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe F","family":"Casanueva","sequence":"additional","affiliation":[{"name":"Department of Medicine, CIBER de Fisiopatolog\u00eda Obesidad y Nutricion, Instituto 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