原发性醛固酮增多症患者糖代谢紊乱的患病情况

Prevalence of glucose metabolism disturbance in primary aldosteronism

目的评价原发性醛固酮增多症(下称原醛症)患者糖代谢紊乱的患病情况。方法检测115例原醛症患者的血压、血尿醛固酮、血尿电解质、血浆肾素活性基础及激发值,并行OGTT。结果(1)原醛症患者中糖代谢紊乱患病率为47.0%,其中糖耐量减低者29.6%,糖尿病者17.4%。(2)根据OG-TT结果分为伴有糖代谢紊乱组(组1)及不伴有糖代谢紊乱组(组2)。两组进行比较,组1年龄大于组2,OGTT各点血糖均以组1为高,组1餐后60、120及180min血胰岛素较组2为高,两组空腹及餐后30min血胰岛素比较差异无统计学意义,两组ISI、HOMA-IR、AUCG及AUCI比较差异有统计学意义。(3)组1血醛固酮高于组2,血钾低于组2;两组尿醛固酮、血浆肾素活性基础值及激发值、尿钾、收缩压及舒张压比较,差异均无统计学意义。结论原醛症患者糖代谢紊乱的患病率升高,一经确诊,即应积极治疗。

Objective To evaluate glucose metabolism disturbance in patients with primary aldosteronism （PA）. Methods One hundred and fifteen patients with PA were evaluated. In all of them, blood pressure, plasma and urinary aldosterone, plasma and urinary potassium,basic and upright plasma renin activity （PRA） were measured. They underwent oral glucose tolerance test （OGTT）. Results （1） The prevalence of glucose metabolism disturbance was 47.0 % in patients with primary aldosteronism,including 29.6% patients of glucose intolerance and 17.4% patients of diabetes mellitus. （2）According to the results of OGTT, we divided all patients into two groups, PA with （group 1）or without （group 2）glucose metabolism disturbance. The patients of group 1 were elder than of group 2. The plasma glucose was higher in group 1 than in group 2 during OGTT. The 60,120 and 180 min OGTT plasma insulin was higher in group 1 than in group 2. （3）The patients of group 1 had higher plasma aldosterone and lower plasma potassium than those of group 2. There were no differences in urinary aldosterone,basic and upright PRA,urinary potassium,systolic and diastolic pressure between two groups. Conclusions Our study indicates that patients with primary aldosteronism have a significantly high prevalence of glucose metabolism disturbance.