Serum prolactin and gonadal hormones in hemodialysis women: a meta-analysis

Background A meta-analysis followed by PRISMA 2020 statement was performed aiming to present a whole prolactin and sex hormone profile in hemodialysis women. Methods Literatures were searched in PubMed, Cochrane library, Embase, and Web of science before March 11, 2023. Trial sequential analysis (TSA) was performed to test the conclusiveness of this meta-analysis. Egger's test and trim-and-fill analysis was used to test publication bias. We took standardized mean difference (SMD) as pool effect of hormones values including prolactin (PRL), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E.sub.2) and progesterone (P). This study was registered in PROSPERO and the number was CRD42023394503. Results Twenty-two articles from 13 countries were analyzed. Combining the results of TSA and meta-analysis, we found that compared with healthy control, hemodialysis women had higher PRL, follicular FSH and LH values and lower P levels (PRL: I.sup.2 = 87%, SMD 1.24, 95% CI: 0.79-1.69, p < 0.00001; FSH: I.sup.2 = 0%, SMD 0.34, 95% CI: 0.13-0.55, p = 0.002; LH: I.sup.2 = 39%, SMD 0.64, 95% CI: 0.34-0.93, p < 0.00001; P: I.sup.2 = 30%, SMD - 1.62, 95% CI: -2.04 to -1.20, p < 0.00001). What's more, compared with women after renal transplantation, hemodialysis women had higher PRL levels (I.sup.2 = 0%, SMD 0.51, 95% CI: 0.25-0.78, p = 0.0001). There was not enough evidence to draw a conclusion on the comparison of hormones between regular and irregular menses hemodialysis women. Egger's test and trim-and-fill analysis didn't show significant publication bias. Conclusions Hemodialysis women had higher serum PRL, follicular phase FSH, LH and lower serum P values compared with healthy control. PRL values of hemodialysis women were also higher than that of women after renal transplantation. Keywords: Hemodialysis, Sex hormones, Prolactin, Luteinizing hormone, Follicle-stimulating hormone