This article entitled “Impact of gender on the association between low serum prolactin and left ventricular mass in subjects with prediabetes,” along with that published by El-Eshmawy et al. [9], evaluated the association between serum prolactin level and cardiac remodeling in patients with prediabetes according to gender. It is helpful that the association between serum prolactin levels and other parameters were evaluated separately for each gender, as serum prolactin levels can be regulated differently between genders. Estrogen is believed to play a central role in the control of prolactin release. In this study, physiologically low serum prolactin was an independent predictor of increased left ventricular mass and left ventricular hypertrophy in adult men, but not in women. Determining the exact biologic mechanism underlying these differences was not possible because it was a cross sectional study. However, this approach is quite valuable in establishing a potential gender-specific diagnostic biomarker for cardiac remodeling in patients with prediabetes. The authors have clearly shown their results in this manuscript.

In my opinion, it would have added more value to their findings if they measured and adjusted for the effect of sex hormones and sex hormone-binding globulins as a potential confounding factors, which would have demonstrated the results more clearly.