肾上腺皮质腺瘤患者代谢综合征的患病情况

Metabolic syndrome in patients with adrenocortical adenoma

目的评价肾上腺皮质腺瘤患者代谢综合征症状的发病情况。方法检测61例肾上腺醛固酮瘤(组1)、23例皮质醇瘤(组2)及24例无功能瘤患者(组3)的代谢综合征相关指标(腰围、血压、血脂及空腹血糖),同时检测患者血、尿醛固酮及皮质醇、血促肾上腺皮质激素、血浆肾素活性、血钾等。与26例正常对照组(组4)进行比较。结果根据美国国家胆固醇教育计划成人治疗组指南标准(NCEP-ATP)Ⅲ标准,4组代谢综合征的患病率分别为17例(27·9%)、9例(39·1%)、4例(16·7%)及3例(11·5%)。醛固酮瘤组腹型肥胖者占26·2%,皮质醇瘤组占39·1%,高于无功能瘤组(20·8%)及对照组(15·4%)。4组高血压患病率比较以醛固酮瘤患者最高,皮质醇瘤患者次之,无功能瘤及对照组最低(98·4%、87·0%、50·0%、38·5%),4组收缩压比较亦体现这一趋势,舒张压比较醛固酮瘤组高于其余3组。4组脂代谢紊乱的患病率以皮质醇瘤组最高(65·2%),醛固酮瘤组次之(44·3%),无功能瘤组为39·1%,对照组最低(30·8%);高血糖的患病率分别为13·1%(8例)、26·1%(6例)、8·7%(2例)及7·7%(2例)。结论肾上腺皮质腺瘤患者代谢综合征的患病率升高,如高血压、脂代谢紊乱、高血糖及腹型肥胖,尤其是皮质醇瘤患者代谢综合征及其相关组成症状的患病率升高明显,醛固酮瘤患者亦有较大升高。

Objective To investigate the prevalence and characteristics of metabolic syndrome （MS） in patients of adrenoeortical adenoma. Methods MS-related indexes, including waist circumference （WC）, blood pressure, triglyceride （TG）, high-density lipoprotein cholesterol （HDL-C）, fasting plasma glucose, plasma and urinary aldosterone, plasma potassium, basic and upright plasma renin activity （PRA）, plasma and urinary cortisol, and plasma ACTH, were examined among 61 patients of aldosterone producing edenoma （ APA, Group 1 ）, 23 patients of cortisol-secreting edenoma （ CSA, Group 2） , 24 patients of nonfunctional adrenal edenoma （ NAA, Group 3 ）, and 26 healthy controls （ Group 4）. Results As defined by the National Cholesterol Education Program Adult Treatment Panel m criteria, the prevalence rates of MS were 27.9%, 39.1%, 16.7%, and 11.5 % in Groups 1,3, 3, and 4. The abdominal obesity rate was 26.2% in Group 1 and 9. 1% in Group 2, beth significantly higher than those of Group 3 and 4 （20.8% and 15.4% respectively）. The prevalence rates of hypertension and systolic blood pressure were the highest in Group 1, followed by Group2, 3, and 4 t. The diastolic blood pressure in patients of Group 1 was also higher than those of the other three groups. The prevalence rates of hypertriglyceride were 24.6%, 52.2%, 21.7%, and 23.1% in Group2 1 -4. The prevalence rates of low HDL-C was 32.8%, 47.8%, 30.4%, and 26.9% respectively. The prevalence rates of hyperglycemia were 13.1%, 26. 1%, 8.7%, and 7. 7% respectively. Conclusion Patients with adrenocortical edenoma have a significantly high prevalence of metabolic syndrome, especially the patients of CSA and NAA.