嗜铬细胞瘤患者血浆间甲肾上腺素类物质与血压及糖脂代谢的相关性研究  

Relationship between plasma level of metanephrines and blood pressure, glucose and lipid profiles in patients with pheochromocytoma

作　　者：木良善 苏颋为[1] 姜蕾[1] 蒋怡然[1] 周薇薇[1] 王卫庆[1] 宁光[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌代谢病科上海市内分泌代谢病研究所上海市内分泌代谢病临床医学中心,上海200025

出　　处：《诊断学理论与实践》2015年第4期318-323,共6页Journal of Diagnostics Concepts & Practice

摘　　要：目的 :探讨嗜铬细胞瘤患者血浆间甲肾上腺素类物质(metanephrines,MNs)水平与其血压及糖脂代谢情况间的相关性。方法:纳入2005年6月至2013年9月我院内分泌科经病理证实的193例嗜铬细胞瘤患者,所有患者均接受血浆MNs及代谢指标检测。采用Pearson相关分析、多元线性回归和多元logistic回归分析MNs与血压、血糖及血脂等代谢指标间的相关性。结果:嗜铬细胞瘤患者中合并高血压者占83.4%;伴有明显的糖脂代谢异常,合并糖尿病及血脂异常者分别占35.8%和23.8%。Pearson相关分析显示,间甲肾上腺素(metanephrine,MN)与空腹血糖及糖负荷2 h血糖呈显著正相关(P<0.05);去甲变肾上腺素(normetanephrine,NMN)与收缩压、舒张压、空腹血糖、糖负荷2 h血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及游离脂肪酸呈显著正相关(P<0.05)。多元线性回归分析表明,在校正年龄、性别、体质量指数、吸烟史及饮酒史后,MN与空腹血糖及游离脂肪酸仍显著正相关(P<0.05),NMN与收缩压、舒张压、空腹血糖、糖负荷2 h血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及游离脂肪酸显著正相关(P<0.05)。多元logistic回归分析证实,MN和NMN水平升高的患者糖尿病患病风险增加,且NMN水平升高患者的高血压患病风险增加。结论:嗜铬细胞瘤患者血浆MN、NMN水平与血压及糖脂代谢调控密切相关,且NMN对代谢的影响更为显著。Objective： To investigate the relationship between plasma metanephrines（MNs） and metabolic profile in patients with pheochromocytoma. Methods： A total of 193 patients with pathologically comfirmed pheochromocytoma were recruited from Shanghai Ruijin hospital during June 2005 and September 2013. Plasma MNs and metabolic parameters were measured in all the subjects. Pearson＇s correlation analysis, multiple linear regression and logistic regression were ap-plied to analyze the association of plasma MNs with blood pressure, blood glucose level and lipid. Results： Patients with pheochromocytoma had high prevalence of metabolic disorders. The prevalences of hypertension, diabetes and dyslipi-demia were 83.4%, 35.8% and 23.8%, respectively. Pearson＇s correlation analysis revealed that plasma MN had statistical-ly significant association with fasting blood glucose（FBG）, postprandial blood glucose（PBG）（ P 0.05）, and plasma normetanephrines（NMN） had significant association with systolic blood pressure（SBP）, diastolic blood pressure（DBP）,FBG, PBG, total cholesterol（TC）, high density lipoprotein cholesterol（HDL）, low density lipoprotein cholesterol（LDL） and free fatty acid（FFA）（P〈0.05）. After adjusted for age, sex, body mass index, current smoking and drinking states, multiple linear regression showed that plasma MN was significantly associated with FBG and FFA（ P〈0.05）, plasma NMN was still closely correlated with SBP, DBP, FBG, PBG, TC, HDL, LDL and FFA（P〈0.05）. Logistic regression analysis demonstrated that both high levels of plasma MN and NMN could increase the risk of diabetes, and high concentration of plasma NMN raised the risk of hypertension. Conclusions： Both plasma MN and NMN are significantly associated with regulation of blood pressure, glucose and lipid metabolism, and plasma NMN may have a more significant impact on metabolic profile in patients with pheochromocytoma.

关 键 词：间甲肾上腺素 去甲变肾上腺素 嗜铬细胞瘤 高血压 糖尿病 血脂异常 

分 类 号：R736.6[医药卫生—肿瘤]