醛固酮瘤患者糖代谢紊乱的患病情况

Glucose Metabolism Disturbance in Patients with Aldosterone-producing Adenoma

目的评价醛固酮瘤患者糖代谢紊乱的患病情况。方法检测65例醛固酮瘤患者的血压、血、尿醛固酮、血浆肾素活性基础及激发值,并行口服糖耐量检查,计算胰岛素敏感指数(ISI)、HOMA指数(HOMA IR)、葡萄糖及胰岛素曲线下面积(AUCG,AUCI),将所得结果与40例正常对照组进行比较。结果根据1999年WHO标准,醛固酮瘤患者中伴糖代谢紊乱者44.6%,糖调节受损者21.5%,糖尿病者23.1%,均高于对照组17.5%、10.0%、7.5%。根据OGTT结果将醛固酮瘤患者分为伴有(组1)及不伴有糖代谢紊乱(组2)两组进行比较,组1患者空腹、糖负荷后2h血糖、AUCG及AUCI均高于组2患者,组间比较有统计学差异(P<0.05)。组1患者血醛固酮、收缩压及舒张压高于组2患者,组间比较有统计学差异(P<0.05)。相关性分析结果醛固酮瘤患者AUCG与8:00血醛固酮呈正相关。结论醛固酮瘤患者糖代谢紊乱的患病率升高,而且其原因与醛固酮的高分泌有关。

Objective The purpose of the study was to look for some features of glucose metabolism disturbance in patients with aldosterone-producing adenoma（APA）.Methods Sixty-five patients of APA were evaluated.All of them measured blood pressure,plasma and urinary aldosterone,basic and upright plasma renin activity（PRA）.They underwent oral glucose tolerance test（OGTT） to calculate insulin index（ISI）,HOMA IR,area under the curve of glucose（AUCG） and insulin（AUCI）.The results were compared with 40 controls.Results As defined by WHO,the prevalence of glucose metabolism disturbance was 44.6% in APA group,including 21.5% patients of glucose intolerance and 23.1% patients of diabete mellitus.The data was higher than those 17.5%,10.0% and 7.5% in control group.According to the results of OGTT,we divided all patients into two groups,with or without glucose metabolism disturbance（Group1 and 2）.The data of glucose metalolism,such as fasting and 2h postprandial plasma glucose,AUCG and AUCI in patients of Group 1 were higher than those of Group 2.The patients of Group 1 had higher plasma aldosterone,systolic and diastolic blood pressure than those of Group 2.The level of AUCG was positive correlated with plasma aldosterone in patients with APA.Conclusions Our study indicates that patients with APA have a significantly high prevalence of glucose metabolism disturbance.It is related with over secretion of aldosterone.