糖尿病患者肾上腺意外瘤患病率及其代谢特征  

The incidence and metabolic profiles of adrenal incidentalomas in patients with diabetes

作　　者：刘婴宁 邹显彤 赵唯 姚旬[2] 王乐瑄 周灵丽[1] 张瑞[1] 罗樱樱[1] 李萌[1] 张秀英[1] 朱宇[1] 蔡晓凌[2] 周翔海[1] 韩学尧[1] 纪立农[1] Liu Yingning;Zou Xiantong;Zhao Wei;Yao Xun;Wang Lexuan;Zhou Lingli;Zhang Rui;Luo Yingying;Li Meng;Zhang Xiuying;Zhu Yu;Cai Xiaoling;Zhou Xianghai;Han Xueyao;Ji Linong(Department of Endocrinology and Metabolism,Peking University People's Hospital,Beijing 100044,China;Department of Radiology,Peking University People's Hospital,Beijing 100044,China;School of Basic Medical Sciences,Peking University,Beijing 100191,China)

机构地区：[1]北京大学人民医院内分泌与代谢科,北京100044 [2]北京大学人民医院放射科,北京100044 [3]北京大学基础医学院,北京100191

出　　处：《中华内分泌代谢杂志》2024年第3期192-197,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：北京市科技新星计划(Z191100001119026);北京市科技新星计划交叉学科合作课题(Z211100002121169)。

摘　　要：目的探究糖尿病患者中肾上腺意外瘤的患病率及其代谢特征。方法回顾性选取2020年3月至2021年5月于北京大学人民医院内分泌与代谢科住院的615例糖尿病患者。回顾入院胸部计算机断层扫描(CT)筛查肾上腺意外瘤并通过多平面重建的方法进行确诊。收集受试者相关身体指标、代谢指标及肾上腺功能指标。采用非配对t检验、Mann-Whitney U检验及卡方检验比较有或无肾上腺意外瘤组间代谢特征的差异。回归分析住院糖尿病患者肾上腺意外瘤与血糖、血脂、血压等代谢指标、肾上腺功能指标的相关性。结果615例糖尿病患者中共检出27例合并肾上腺意外瘤(4.4%)。合并肾上腺意外瘤患者的体重指数、腰围及臀围水平显著高于未合并肾上腺意外瘤患者[(29.4±5.1)kg/m^(2)对(26.8±3.8)kg/m^(2),P=0.018;(102.3±11.7)cm对(95.8±10.3)cm,P=0.002;(107.3±10.1)cm对(101.4±7.6)cm,P=0.008]。血尿酸、尿微量白蛋白/肌酐比值也在合并肾上腺意外瘤患者中显著升高[(409.6±118.1)μmol/L对(357.4±100.6)μmol/L,P=0.009;21.25(7.49,180.24)mg/g对8.60(4.71,34.56)mg/g,P=0.010]。另外,合并肾上腺意外瘤患者共患高血压病的风险显著增加(P=0.045)。结论糖尿病患者中肾上腺意外瘤的患病率为4.4%。糖尿病患者合并肾上腺意外瘤者合并肥胖及高血压病的风险增加。Objective To determine the incidence of adrenal incidentalomas(AIs)in patients with diabetes mellitus and the metabolism profiles.Methods A total of 615 hospitalized patients with diabetes mellitus in the Department of Endocrinology and Metabolism of Peking University People′s Hospital from March 2020 to May 2021 were retrospectively included in this study.AIs were screened by unenhanced chest computed tomography(CT)retrospectively and subsequently confirmed by multiplanar reconstruction.Participants′physical indicators,metabolic profiles,and adrenal function parameters were collected.Unpaired t test,Mann-Whitney U test,and Chi-Square test were adopted to compare the metabolism profiles between diabetes mellitus patients with or without AIs.Regression models were used to estimate the correlations between AIs and the metabolism profiles such as blood glucose,blood lipids,blood pressure,and the adrenal function parameters.Results Twenty-seven out of 615 participants were detected with AIs(4.4%).Patients with AIs had higher body mass index,waist circumference,and hip circumference than patients without AIs[(29.4±5.1)kg/m^(2) vs(26.8±3.8)kg/m^(2),P=0.018;(102.3±11.7)cm vs(95.8±10.3)cm,P=0.002;(107.3±10.1)cm vs(101.4±7.6)cm,P=0.008].The levels of serum uric acid and urinary albumin/creatinine ratio were also significantly increased in patients with AIs[(409.6±118.1)μmol/L vs(357.4±100.6)μmol/L,P=0.009;21.25(7.49,180.24)mg/g vs 8.60(4.71,34.56)mg/g,P=0.010].Besides,individuals with AIs were also associated with a higher risk of co-existing hypertension(P=0.045).Conclusion The incidence of AIs in patients with diabetes is 4.4%.The presence of AIs in patients with diabetes may associated with increased risk of obesity and hypertension.

关 键 词：肾上腺意外瘤 糖尿病 计算机断层扫描 高血压 代谢异常 

分 类 号：R587.2[医药卫生—内分泌] R736.6[医药卫生—内科学]