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目的分析功能性肾上腺皮质腺瘤患者代谢综合征(MS)的患病情况。方法对65例肾上腺醛固酮瘤(APA)及43例皮质醇瘤(CSA)患者行MS相关指标检测,包括体质量指数(BMI)、血压、血脂、空腹及糖负荷后2h血糖,同时检测患者血、尿醛固酮及血、尿皮质醇,血促肾上腺皮质激素(ACTH),血浆肾素活性,血钾等激素及生化测值,将所得结果与24例肾上腺无功能瘤(NAA)、53例原发性高血压(EH)患者及40名健康人群对照组进行比较。结果各组MS的检出率分别为APA组38.5%、CSA组41.9%、NAA组20.8%、EH组24.5%及对照组17.5%。APA组患者血、尿醛固酮[血醛固酮(92.9±32.4)pmol/L,尿醛固酮(16.6±9.1)μg/24h]高于其余各组,CSA组血、尿皮质醇[8:00血皮质醇(747.3±300.8)nmol/L,24:00血皮质醇(531.8±269.3)nmol/L,尿皮质醇(220.0±210.8)μg/24h]高于其余各组。CSA组患者超重/肥胖检出率(41.9%)高于其余各组;APA(44.6%)及CSA组(48.8%)高血糖检出率高于其余各组;APA及EH组高血压检出率均为100%;CSA组(72.1%)次之,高于NAA组(50.0%)及对照组(45.0%);APA(55.4%)及CSA组(46.5%)血脂紊乱的检出率高于其余各组。将APA及CSA患者分别分为伴及不伴MS组进行比较,发现伴MS的APA患者血醛固酮高于不伴MS的APA患者[(104.6±26.7)比(85.5±33.9),P<0.05],伴MS的CSA患者8:00及24:00血皮质醇高于不伴MS的CSA患者[8:00血皮质醇(879.0±319.6)比(652.5±252.3)nmol/L,24:00血皮质醇(653.1±278.9)比(444.5±229.8)nmol/L,均P<0.05]。结论功能性肾上腺皮质腺瘤患者MS的检出率升高,可能与肾上腺皮质激素的高分泌相关。
Objective To analyze the prevalence of metabolic syndrome (MS) in patients with functional adrenocortical adenoma. Methods Sixty-five patients with adrenal aldosterone (APA) and 43 patients with cortisol (CSA) were examined with MS, including body mass index (BMI), blood pressure, lipids, fasting blood glucose and blood glucose 2h after glucose load, , Urinary aldosterone and blood, urinary cortisol, blood adrenocorticotropic hormone (ACTH), plasma renin activity, potassium and other hormones and biochemical measurements, the results obtained with 24 cases of adrenal aneurysm (NAA), 53 cases of the original Patients with essential hypertension (EH) and 40 healthy controls were compared. Results The detection rates of MS in each group were 38.5% in APA group, 41.9% in CSA group, 20.8% in NAA group, 24.5% in EH group and 17.5% in control group. In the APA group, blood aldosterone (serum aldosterone (92.9 ± 32.4) pmol / L and urinary aldosterone (16.6 ± 9.1) μg / 24h) was higher in the CSA group than in the other groups (747.3 ± 300.8) nmol / L, 24:00 Cortisol (531.8 ± 269.3) nmol / L and Urinary Cortisol (220.0 ± 210.8) μg / 24h] than the other groups. The detection rate of overweight / obesity in CSA group was higher than that in other groups (41.9%). The detection rate of high blood sugar in APA group (44.6%) and CSA group (48.8%) was higher than that in other groups (100%) in the CSA group (72.1%), followed by the NAA group (50.0%) and the control group (45.0%). The detection rate of the lipid disorder was higher in the APA group (55.4%) and CSA group (46.5% In the remaining groups. Patients with APA and CSA were divided into non-MS group and MSA group, and found that the serum aldosterone levels in APA patients with MS were higher than those in APA patients without MS [(104.6 ± 26.7) vs (85.5 ± 33.9), P <0.05] , The blood cortisol levels at 8:00 and 24:00 with MS in CSA patients were significantly higher than those with CSA without MS [8:00 cortisol (879.0 ± 319.6) vs. (652.5 ± 252.3) nmol / L, bloodshed at 24:00 Cortisol (653.1 ± 278.9) vs (444.5 ± 229.8) nmol / L, all P <0.05]. Conclusion The detection rate of MS in functional adrenocortical adenoma patients may be related to the high secretion of adrenocorticotropic hormone.