原发性醛固酮增多症患者中代谢综合征与左心室重塑的关系  

Relationship between metabolic syndrome and left ventricular remodeling in patients with primary aldosteronism

作　　者：杨凯妮 黄林晶[1,3] 刘东晖 陈秀清[1,3] 黄凌宁 颜晓芳[1,3] 吴佩文 YANG Kai-ni;HUANG Lin-jing;LIU Dong-hui;CHEN Xiu-qing;HUANG Ling-ning;YAN Xiao-fang;WU Pei-wen(Department of Endocrinology,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350005,China;Cardiac Function Examination Room,the First Hospital of Quanzhou City;Clinical Research Center for Metabolic Diseases of Fujian Province)

机构地区：[1]福建医科大学附属第一医院内分泌科,福建福州350005 [2]泉州市第一医院心功能检查室 [3]福建省代谢性疾病临床医学研究中心

出　　处：《中华高血压杂志》2022年第9期849-855,共7页Chinese Journal of Hypertension

基　　金：福建省自然科学基金项目(2020J01951)。

摘　　要：目的探讨原发性醛固酮增多症(PA)患者中代谢综合征(MS)及其组分与左心室重塑的关系。方法收集2015年1月1日至2021年4月15日就诊于福建医科大学附属第一医院并确诊为PA的病例,按性别、年龄(±3岁)、入院血压分级、高血压病程(±3年)进行匹配,纳入PA患者107例和原发性高血压(EH)患者214例进行病例对照研究,比较PA和EH组间临床资料、MS及其组分患病情况及左心室重塑情况。结果PA患者合并MS比例低于EH患者(28.0%比43.0%,χ^(2)=6.770,P=0.010),而左心室异常构型率高于EH患者(64.5%比34.6%,χ^(2)=25.827,P<0.05),左心室异常构型中的向心性重构、向心性肥厚、离心性肥厚的异常构型率高于EH患者(分别为21.5%比11.7%,χ^(2)=5.401;19.6%比9.8%,χ^(2)=6.040;23.4%比13.1%,χ^(2)=5.469;均P<0.05)。二元logistic回归分析显示,MS及其组分高血糖是PA患者左心室重塑异常构型的独立危险因素(分别OR=4.866,95%CI 1.523~15.543;OR=9.437,95%CI 1.975~45.090;均P<0.05)。结论与性别、年龄、入院血压分级、高血压病程相匹配的EH患者相比,PA患者左心室重塑更为严重,MS及其组分高血糖是PA患者左心室重塑的独立危险因素。Objective To investigate the relationship between metabolic syndrome(MS)and its components and left ventricular(LV)remodeling in patients with primary aldosteronism(PA).Methods A case-control study was conducted.Between January 1,2015 and April 15,2021,a total of 107 PA and 214 essential hypertension(EH)patients individually matched by sex,age(±3 years),blood pressure,and duration(±3 years)of hypertension were recruited from the First Affiliated Hospital of Fujian Medical University.Clinical data,the prevalence of MS and its components,as well as the LV remodeling were compared between the two groups.Results The prevalence of MS in PA group was significantly lower than that in matched EH group(28.0%vs 43.0%,χ^(2)=6.770,P=0.010),whereas the abnormal LV configuration in PA group was higher than in EH group(64.5%vs 34.6%,χ^(2)=25.827,P<0.05).The abnormal conformation rates of centripetal remodeling,centripetal hypertrophy,and centrifugal hypertrophy in PA patients were higher than in EH patients(21.5%vs 11.7%,χ^(2)=5.401;19.6%vs 9.8%,χ^(2)=6.040;23.4%vs 13.1%,χ^(2)=5.469;respectively,all P<0.05).Binary logistic regression analysis showed that MS and its component hyperglycemia were independent risk factors for the abnormal configuration of LV remodeling in PA patients(OR=4.866,95%CI 1.523-15.543 and 9.437,95%CI 1.975-45.090,respectively,both P<0.05).Conclusions PA patients exhibit more severe LV remodeling than matched EH controls.MS and its component hyperglycemia are independent risk factors for LV remodeling in patients with PA.

关 键 词：原发性醛固酮增多症 代谢综合征 左心室重塑 

分 类 号：R586.24[医药卫生—内分泌]