论文部分内容阅读
目的探讨低血钾在原发性醛固酮增多症包括肾上腺醛固酮分泌腺瘤(APA)、特发性醛固酮增多症(IHA)患者糖、胰岛素代谢中的作用。方法根据有无低血钾将178例原发性醛固酮增多症患者(APA103例、IHA75例)分为低血钾组和正常血钾组,2组均行3h口服葡萄糖耐量试验和卧立位醛固酮试验,观察血糖、胰岛素变化与血钾之间的关系。结果低血钾组血钾曲线下面积、胰岛素曲线下面积、空腹胰岛素水平均低于正常血钾组(P<0·05,P<0·01);低血钾组血糖曲线下面积、卧位醛固酮水平均高于正常血钾组(P<0·05);低血钾组糖耐量异常者为75·3%,正常血钾组为48·5%,两组比较差异具有显著性(P<0·01)。APA和IHA中代谢综合征的患病率分别为38·8%、57·3%,两者比较差异具有显著性(P<0·05)。结论低血钾是导致原发性醛固酮增多症患者中胰岛素分泌下降的可能原因之一;应警惕原发性醛固酮增多症患者合并代谢综合征的情况,并及时纠正其可能存在的代谢紊乱。
Objective To investigate the role of hypokalemia in the metabolism of glucose and insulin in patients with primary aldosteronism, including adrenal aldosterone secreting adenoma (APA) and idiopathic aldosteronism (IHA). Methods According to the presence or absence of hypokalemia, 178 patients with primary aldosteronism (APA 103 cases, IHA75 cases) were divided into hypokalemia group and normal potassium group, two groups were given 3h oral glucose tolerance test and lying position aldosterone Test, observe the relationship between blood glucose, insulin changes and serum potassium. Results The area under the curve of serum potassium, the area under the curve of insulin and the level of fasting insulin in hypokalemia group were lower than those in the normal potassium group (P <0.05, P <0.01). The area under the hyperglycemia group in the blood glucose curve was Aldosterone levels were higher than the normal potassium group (P <0.05); hypoglycemic group was impaired glucose tolerance was 75.3%, normal potassium group was 48.5%, the difference between the two groups was significant ( P <0.01). The prevalence of metabolic syndrome in APA and IHA was 38.8% and 57.3%, respectively, with significant difference (P <0.05). Conclusions Hypokalemia is one of the possible reasons leading to the decrease of insulin secretion in patients with primary aldosteronism. Patients with essential aldosteronism should be wary of metabolic syndrome, and correct the possible metabolic disorder in time.