摘要
目的探讨醛固酮瘤患者高血糖的患病情况。方法选取2000—2010年本院收治的65例醛固酮瘤患者(醛固酮瘤组)、53例原发性高血压患者(原发性高血压组)及40例体检健康者(对照组)。检测并比较3组受试者的血压、血钾、血醛固酮、尿醛固酮、血浆肾素活性(PRA)基础及激发值,并行口服葡萄糖耐量试验(OGTT),计算胰岛素敏感指数(ISI)、稳态模型胰岛素抵抗指数(HOMA-IR)、葡萄糖及胰岛素曲线下面积(AUCG、AUCI)。采用Pearson检验分析醛固酮与血糖间的相关性。结果 (1)醛固酮瘤组患者血压、血醛固酮、尿醛固酮、AUCG、AUCI均高于原发性高血压组及对照组,HOMA-IR高于对照组,而血钾、基础及激发PRA值则较后两组降低,组间比较差异均有统计学意义(P<0.05)。(2)OGTT结果显示,醛固酮瘤组高血糖患病率为44.6%(29/65),高于原发性高血压组的24.5%(13/53)及对照组的17.5%(7/40),组间比较差异有统计学意义(P<0.05);醛固酮瘤组患者糖调节受损及糖尿病患病率分别为23.1%(15/65)和21.5%(14/65),而原发性高血压组则为13.2%(7/53)和11.3%(6/53),对照组为10.0%(4/40)和7.5%(3/40)。(3)相关性分析显示,醛固酮瘤组患者8:00血醛固酮与糖负荷后2 h血糖(2 hPG)及AUCG均呈正相关(r值分别为0.250和0.289,P值分别为0.044和0.019),血钾与2 hPG及AUCG均呈负相关(r值分别为-0.301和-0.304,P值分别为0.015和0.014)。(4)根据OGTT结果将醛固酮瘤组患者分为伴及不伴高血糖组,前者血醛固酮水平高于后者,差异有统计学意义(P<0.05)。结论醛固酮瘤患者高血糖患病率较健康者及原发性高血压患者升高。
Objective To investigate the prevalence of hyperglycemia in patients with aldosterone - producing adeno- ma （APA） . Methods 65 APA patients （APA group） admitted to our hospital from 2000 to 2010, 53 essential hypertension patients （ EH group） and 40 healthy people （ control group） were involved into the study. Blood pressure, plasma potassium, plasma aldosterone, urine aldosterone, basic and upright PRA value were measured and OGTr was performed among these sub- jects. ISI, HOMA- IR, AUCG, AUC1 were calculated. Pearson correlation analysis was performed to study the correlation be- tween aldosterone and blood glucose. Results （1） The systolic and diastolic blood pressure, plasma and urinary aldosterone, AUCG and AUC1 in patients of APA group were significantly higher than those of EH and control groups, the HOMA - IR in APA group was significantly higher than that of control group, but the plasma potassium, basic and upright PRA were significantly low- er than PA and control groups （P 〈0.05） . （2） According to OGTT, the prevalence of hyperglycemia was 44. 6% （29/65） in APA group, including 23.1% （15/65） patients of glucose intolerance and 21.5% （14/65） patients of diabetes meUitus, was significantly higher than that of EH and control groups, which were 24. 5% （13/53） and 17. 5% （7/40） respectively. （3） Correlation analysis showed that the level of plasma aldosterone was positively correlated with 2 h postprandial glucose and AUCG in APA patients （r =0. 250, 0. 289; P =0. 044, 0. 019） . And the level of plasma potassium was negatively correlated with 2 h postprandial glucose and AUCG in APA patients （ r = - 0. 301, - 0. 304 ; P = 0. 015, 0. 014） . （4） According to the results of OGTT, all APA patients were divided into with or without hyperglycemia groups. The APA patients with hyperglyce- mia had higher plasma aldosterone than those without hyperglycemia （ P 〈 0. 05 ） . Conclusion Patients with APA have a signif- icantly higher prevalence of hyperglycemia.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第36期4183-4186,共4页
Chinese General Practice
关键词
醛固酮瘤
高血压
高血糖症
糖尿病
Aldosterone - producing adenoma
Hypertension
Hyperglycemia
Diabetes mellitus
