陕西宝鸡地区2型糖尿病患者合并肾上腺意外瘤调查及其代谢效应

Prevalence and metabolic characteristics of adrenal incidentalomas in patients with type 2 diabetesmellitus in Baoji, Shaanxi Province

目的调查2型糖尿病（T2DM）患者中肾上腺意外瘤（AIs）的患病率，评定AIs的性质和代谢效应。 方法选择2014年8月至2015年7月住院的T2DM患者，进行肾上腺CT平扫，筛查AIs，内分泌功能评定是否嗜铬细胞瘤、原发性醛固酮增多症（PA）、亚临床库欣综合征（SCS），临床鉴别良恶性，并比较有或无AIs的多项代谢指标。组间比较采用非配对t检验或非参数检验。 结果563例T2DM患者共检出22例合并AIs （3.91%），其中PA 2例（0.36%）、SCS 4例（0.71%）、无功能瘤16例（2.84%）。有AIs的T2DM患者糖化血红蛋白、空腹C肽、甘油三酯、收缩压、舒张压均明显高于无AIs者（z=-2.832、-3.650、-2.661、-3.134、-2.867，均P〈0.05）。

Obiective To explore the prevalence and metabolic characteristics of adrenal incidentalomas （AIs） in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 563 patients with T2DM were recruited fl＇om August 2014 to July 2015. AIs were screened by adrenal CT scan, their functional types were classified by endocrine function evaluation. Metabolic parameters were compared between the T2DM patients with and without AIs. Unpaired t test or nonparametrie test was performed for comparisons between groups. Results Of 22 patients who were detected with AIs, 2 had primary aldosteronism （0.36%）, 4 had subclinical Cushing＇s syndrome （0.71%）, and 16 had nonfunctional adenomas （2.84%）. Compared with the T2DM patients without AIs, levels of plasma glycated hemoglobin A, fasting C peptide, triglyceride, systolic and diastolic blood pressure were significantly increased in the T2DM patients with AIs （z=-2.832,-3.650,-2.661,-3.134,-2.867, respectively, all P〈0.05）. Conclusions The prevalence of AIs in T2DM patients is 3.91%. The incidence rate of metabolic syndrome is much higher in T2DM patients with AIs than in those without AIs.