Correlation between serum mammalian target of rapamycin level,immune function indexes and bromocriptine resistance in patients with pituitary prolactinoma

Zhang Qian; Zhang Cheng; Gao Feng; Parehatijiang Yizimu; Dong Jun; Wu Yonggang

doi:10.3760/j.issn.1673-4777.2025.05.011

Abstract：Objective To investigate the correlation of serum mammalian target of rapamycin(mTOR)level and immune function indexes with bromocriptine resistance in patients with pituitary prolactinoma.Methods A total of 120 patients with pituitary prolactinoma admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to May 2024 were selected as the research objects.According to the response to bromocriptine treatment,all patients were divided into sensitive group(78 cases)and resistant group(42 cases).The clinical data,serum mTOR level and immune function indexes of the two groups were compared.The correlation between serum mTOR and immune function indexes was analyzed.Generalized linear mixed model was constructed to analyze the relationship between serum mTOR,immune function indexes and bromocriptine resistance.Restricted cubic spline was used to analyze the dose-response relationship between serum mTOR,immune function indexes and bromocriptine resistance.Receiver operating characteristic curve was used to analyze the diagnostic efficacy of serum mTOR and immune function indexes in bromocriptine resistance.Results There was a significant negative correlation between mTOR level and CD3+,CD4+,and the CD4+/CD8+ratio,and a significant positive correlation between mTOR level and CD8+(all P＜0.05).The results of generalized linear mixed model analysis showed that with the increase of mTOR and CD8+,the risk of bromocriptine resistance in patients increased significantly,and with the increase of CD3+,CD4+,and CD4+/CD8+ratio,the risk of bromocriptine resistance in patients decreased significantly.The results of restricted cubic spline model showed that there was a significant nonlinear dose-response relationship between serum mTOR expression level and immune function indicators and bromocriptine resistance(P＜0.05).The area under the curve of serum mTOR combined with immune function indicators to predict the resistance of patients with bromocriptine was 0.896(95％confidence interval:0.627-0.985),and the sensitivity and specificity were 91.85％and 92.53％,respectively.Conclusion In patients with pituitary prolactinoma,there is a significant correlation between serum mTOR level and immune function indicators,and both of them have been identified as important risk factors for bromocriptine resistance.