{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T21:15:32Z","timestamp":1770758132881,"version":"3.50.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Obesity"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The occurrence of patients with lactotroph adenoma presenting with class III obesity is extremely rare. This study reports long\u2010term outcomes of such patients treated with transsphenoidal surgery (TSS) or dopamine agonists (DAs) and integrates findings with existing literature to explore prolactin's (PRL) role in obesity pathophysiology. We analysed BMI and metabolic changes and compared findings with published case series. Four patients presented with class III obesity (BMI range, 40.0\u201343.1\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ). The diagnostic work\u2010up revealed hyperprolactinemia (PRL range, 56.1\u20134389\u2009\u03bcg\/L) and hypogonadism in all patients, with sellar MRI indicating a macroadenoma in all but one patient. Over a median follow\u2010up of 31\u2009months (range 24\u2013144), both TSS (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092) and DAs (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092) effectively controlled hyperprolactinemia and hypogonadism. BMI changes (\u0394BMI\/year) were \u22121.4\u2009\u00b1\u20091.8\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \/year (TSS) and \u22123.9\u2009\u00b1\u20093.4\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \/year (DAs), with non\u2010significant metabolic improvements. Analysis of 22 additional cases revealed similar trends. Higher baseline BMI and macroprolactinoma were risk factors for persistent obesity. Early PRL screening in patients with class III obesity, weight loss interventions and long\u2010term hyperprolactinemia management are essential. Both TSS and DAs provide metabolic benefits, highlighting the need for a multidisciplinary approach in diagnosing and managing lactotroph adenomas with obesity.\n                  <\/jats:p>","DOI":"10.1111\/cob.70067","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:38:42Z","timestamp":1769060322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Class\n                    <scp>III<\/scp>\n                    Obesity as a Presenting Syndrome in Prolactinoma Patients: Insights Into Obesity and Metabolic Dysfunction in This Unique Group"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1764-688X","authenticated-orcid":false,"given":"Lukas","family":"Andereggen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Kantonsspital Aarau  Aarau Switzerland"},{"name":"Faculty of Medicine University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Clinical Nutrition University Hospital Zurich and University of Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Br\u00e4ndle","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes Cantonal Hospital St. Gallen  St. Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuel","family":"Christ","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism University Hospital of Basel  Basel Switzerland"},{"name":"Department of Clinical Research University of Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.113905"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1285477"},{"issue":"4","key":"e_1_2_14_4_1","first-page":"392","article-title":"Prolactinoma and Body Weight: A Retrospective Study","volume":"125","author":"Creemers L. 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