原发性高血压合并无功能肾上腺意外瘤患者代谢综合征患病情况分析

The incidence of metabolic syndrome in patients with primary hypertension and non-functional adrenal incidentaloma:a single center study

目的:探讨原发性高血压合并无功能肾上腺意外瘤(NFAI)患者代谢综合征(MS)发生情况及其与皮质醇分泌水平的相关性。方法:复旦大学附属中山医院内分泌科2014年10月至2015年4月收治的原发性高血压合并NFAI患者56例(NFAI组),原发性高血压肾上腺形态正常者58例(EH组)。收集身高、体质量、腹围、血压等体格检查参数;测定电解质,血脂谱,空腹及餐后2h血糖水平,以及隔夜1 mg地塞米松试验(ONDST)后皮质醇水平。根据有无代谢综合征(MS),分别将NFAI组和EH组患者分为MS组(MS组)和非MS组(NMS组),比较各组ONDST后皮质醇水平。结果:NFAI组患者舒张压、体质指数(BMI)、腹围、餐后2h血糖、三酰甘油、ONDST后皮质醇水平高于EH组患者(P<0.05)。56例NFAI组患者中,22例(39.2%)合并MS,高于EH组患者(14例,24.1%,P<0.05)。NFAI组患者中,MS亚组患者ONDST后皮质醇水平高于NMS亚组患者(P<0.05)。随着NFAI组患者MS组分数量异常增加,ONDST后皮质醇水平逐渐升高。结论:原发性高血压合并NFAI患者MS患病率较高,其MS发生与ONDST后皮质醇水平相关。

Objective：To investigate the incidence of metabolic syndrome in patients with primary hypertension and non-functional adrenal incidentaloma（NFAI）and to analyze the correlation between the metabolic syndrome and the cortisol levels.Methods：Fifty-six primary hypertension patients combined with NFAI（NFAI group）and 58 primary hypertension patients with normal adrenal morphology（EH group）admitted in the Department of Endocrinology,Zhongshan Hospital between October 2014 and April 2015 were selected.Physical examination parameters such as height,weight,abdominal circumference,and blood pressure were collected.Electrolytes,lipid profiles,fasting and 2-h postprandial blood glucose（2-h PG）levels,and the cortisol levels after the overnight 1-mg dexamethasone test（ONDST）were analyzed.The patients in NFAI and EH groups were further divided into metabolic syndrome group（MS group）and non-metabolic syndrome group（NMS group）,the cortisol levels after ONDST were compared among different groups.Results：Diastolic blood pressure,body mass index（BMI）,abdominal circumference,2-h PG,triglyceride,and ONDST cortisol levels were significantly higher in the NFAI group than those in the EH group（P〈0.05）.There were 22 patients（39.2%）with metabolic syndrome in the 56 NFAI patients,and the proportion was higher than that of the EH group（14 patients,24.1%,P〈0.05）.In the NFAI group,the cortisol level after ONDST in the MS subgroup was significantly higher than that in the NMS subgroup.The abnormal number of metabolic syndrome in the NFAI group gradually increased along with the cortisol level after ONDST.Conclusions：The prevalence of metabolic syndrome in primary hypertension patients combined with NFAI is relatively high,which is correlated with the cortisol level after ONDST.