棕色脂肪组织在不同肾上腺肿瘤周围脂肪组织中的表达及意义  

Significance and expression of periadrenal brown adipose tissue in different types of adrenal adenoma

作　　者：成康[1] 余忠伟[1] 曹万里[1] 黄宝星[1] 宿恒川[1] 孙福康[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《现代泌尿外科杂志》2016年第8期632-635,共4页Journal of Modern Urology

基　　金：上海市教委科研创新项目(No.14YZ050)

摘　　要：目的观察棕色脂肪组织在不同肾上腺肿瘤周围脂肪组织中的表达差异及其与患者代谢风险之间的联系。方法 62例行肾上腺肿瘤切除术的患者(25例醛固酮腺瘤,13例柯兴腺瘤,15例无功能腺瘤,9例嗜铬细胞瘤)和12例在我院行肾切除术的患者被纳入本研究。通过测定肾上腺周围脂肪中解耦连蛋白1的表达量来确定棕色脂肪组织的含量。收集血醛固酮,24 h尿皮质醇以及其他临床指标的数据以研究过度分泌的肾上腺皮质激素对肾上腺周围棕色脂肪组织的表达的影响。结果醛固酮腺瘤组的棕色脂肪组织表达率显著高于柯兴腺瘤组的(P=0.011),而嗜铬细胞瘤组的棕色脂肪组织表达率要显著高于柯兴腺瘤组(P=0.003)和肾癌组的(P=0.024)。棕色脂肪组织的表达量和血醛固酮水平无相关性(r_s=-0.391,P=0.121),和尿24 h皮质醇和棕色脂肪组织表达量呈负相关(r_s=-0.325,P=0.029),和MNs(血变肾上腺素+血去甲变肾上腺素)呈正相关(r_s=286,P=0.031)。棕色脂肪组织的表达量和患者的体重指数(body mass index,BMI)(r_s=-0.257,P=0.027)、腹部脂肪(r_s=-0.444,P<0.001)、空腹血糖(r_s=-0.294,P=0.034)和空腹血清C肽(r_s=-0.684,P=0.002)均呈负相关。结论棕色脂肪组织在不同肾上腺肿瘤类型的肾上腺周围脂肪中的表达量存在明显的差异,并且棕色脂肪组织的表达量可能和患者发生代谢综合症的风险性密切相关。Objective To determine the expression of brown adipose tissue in perirenal adipose tissue around different types of adrenal tumors and to estimate its relationship with metabolic risks. Methods A total of 62 cases （25 aldosterone producing adenoma, 13 cortisol producing adenoma, 15 nonfunctioning adrenal adenoma and 9 pheochromacytoma） who un- derwent adrenalectomy and 12 patients who received nephrectomy were enrolled into this study. Uncoupling protein 1 in the periadrenal adipose tissue was measured to determine the presence of brown adipose tissue. Serum aldosterone level, 24-hour u- rinary cortisol and other clinical data were collected to study the effect of excessively secreted adrenal cortical hormone on brown adipose tissue. Results Brown adipose fraction was significantly higher in aldosterone producing adenoma group than in cortisol producing adenoma group （P = 0. 011）. Brown adipose fraction was significantly higher in pheochromacytoma group than in cortisol producing adenoma group and renal carcinoma group. Brown adipose fraction wasn＇t correlated with serum al- dosterone levels （rs = -0. 391, P=0. 121）. Brown adipose content was negatively correlated with 24-hour urinary free cortisol and positively correlated with MNs level （serum metanephrine plus serum normetanephrine） （rs = 286, P = 0.031）. Brown adi- pose fraction was negatively correlated with BMI （ rs = -- 0. 257, P = 0. 027）, visceral fat （ rs = -0. 444, P〈0. 001）, fasting se- rum glucose（rs=-0.294, P=0.034） and fasting serumC-peptide（rs=-0.684, P=0.002）. Conclusions Brown adipose tissue presents differentially in patient＇s periadrenal adipose tissue in different types of adrenal neoplasmas. Brown adipose fraction is closely related to metabolic risks.

关 键 词：肾上腺肿瘤 棕色脂肪组织 中央型肥胖 代谢风险 

分 类 号：R586[医药卫生—内分泌]