嗜铬细胞瘤/副神经节瘤患者血浆MNs与血脂、血糖、血压的相关性分析

Correlation of plasma level of MNs to blood lipid, blood glucose and blood pressure in patients with pheochromocytoma/paraganglioma

目的 探讨嗜铬细胞瘤(PCC)/副神经节瘤(PGL)(合称PPGL)患者血浆甲氧基肾上腺素(MN)及甲氧基去甲肾上腺素(NMN)(合称MNs)与血脂、血糖、血压的相关性。方法 回顾性分析2017年1月-2018年6月在解放军总医院第一医学中心手术病理确诊的PPGL64例临床资料。根据术前血浆MN三分位数将64例分为T1(n=21)、T2(n=21)、T3(n=22)组,再根据术前血浆NMN三分位数将其分为T'1(n=21)、T'2(n=21)、T'3(n=22)组。分析MNs与血脂、血糖、血压等指标的相关性。结果 PPGL患者中随血浆MNs的水平升高,体重指数(BMI)值明显下降;随血浆NMN的水平升高,高密度脂蛋白胆固醇(HDL-C)、收缩压(SBP)明显升高(P<0.05)。Pearson相关分析显示,血浆MN与BMI呈明显负相关(r=–0.319,P=0.010),与肿瘤直径呈明显正相关(r=0.268,P=0.032)。血浆NMN与BMI呈明显负相关(r=–0.353,P=0.004),与SBP、空腹血糖(FBG)、总胆固醇(TG)、HDL-C、肿瘤直径呈明显正相关(r分别为0.256、0.019、0.047、0.001、0.003,P<0.05)。多元线性回归分析结果显示,在校正年龄、性别、吸烟史、饮酒史后,血浆MN与BMI呈明显负相关(β=–0.09,P=0.004),与肿瘤直径呈明显正相关(β=0.04,P=0.016);血浆NMN与BMI呈明显负相关(β=–0.08,P=0.006),与SBP、FBG、TG、HDL-C、肿瘤直径呈明显正相关(β分别为0.01、0.13、0.18、0.50、0.06,P<0.05)。结论 血浆MNs水平与血脂、血糖、血压的调控有关,术前血浆MNs水平较高的患者更需注意高血压、高FBG的发生。

Objective To investigate the correlations of plasma methoxyadrenaline(MN)and methoxynorepinephrine(NMN)(collectively called MNs)to blood lipid,blood glucose and blood pressure in patients with pheochromocytoma(PCC)and paraganglioma(PGL)(collectively called PPGL).Methods The clinical data were retrospectively analyzed of 64 patients with pathologically confirmed PPGL in Chinese PLA General Hospital during Jan.2017 to Jun.2018.According to the tertiles plasma MN before operation,the 64 cases were divided into T1(n=21),T2(n=21)and T3(n=22)group,and then were divided into T'1(n=21),T'2(n=21)and T'3(n=22)group according to the tertiles plasma NMN before operation.The correlations were analyzed of plasma level of MNs to the blood lipid,blood glucose and blood pressure.Results The body mass index(BMI)value decreased significantly with the increase of plasma MNs level in patients with PPGL.With the increase of plasma NMN level,high density lipoprotein cholesterol(HDL-C)and systolic blood pressure(SBP)increased significantly(P<0.05).Pearson correlation analysis showed that the plasma MN was negatively correlated with BMI(r=–0.319,P=0.010),and positively correlated with the tumor diameter(r=0.268,P=0.032).The plasma NMN was negatively correlated with BMI(r=–0.353,P=0.004),and positively correlated with SBP,fasting blood glucose(FBG),total cholesterol(TG),HDL-C,and tumor diameter(r=0.256,0.019,0.047,0.001 and 0.003,respectively.P<0.05).The multivariate linear regression analysis showed that the plasma MN was negatively correlated with BMI(β=0.09,P=0.004)and positively correlated with tumor diameter(β=0.04,P=0.016).Plasma NMN was negatively correlated with BMI(β=0.08,P=0.006),and positively correlated with SBP,FBG,TG,HDL-C,tumor diameter(β=0.01,0.13,0.18,0.50 and 0.06,respectively.P<0.05).Conclusions The plasma MNs level is related to the regulation of blood lipid,blood sugar and blood pressure.Patients with high plasma MNs level before operation should pay more attention to the occurrence of hypertension and high FBG.