Influence of Adrenal Subclinical Hypercortisolism on Hypertension in Patients with Adrenal Incidentaloma
Influence of Adrenal Subclinical Hypercortisolism on Hypertension in Patients with Adrenal Incidentaloma
复制标题
DOI：
10.1055/s-0032-1301896
复制
发表时间：
2012-04-01
影响因子：
1.8
通讯作者：
Kohno, N.
中科院分区：
文献类型：
--
作者：
Oki, K.;Yamane, K.;Kohno, N.
目的：我们研究的目的是澄清是否细微的产生皮质醇的肿瘤，如亚临床库欣综合征（SubCS）和亚临床高皮质醇症（SH），影响高血压的患病率，因为许多基础研究已经注意到糖皮质激素过量会影响血压。方法：80例肾上腺皮质腺瘤患者（女性39例，男性41例，平均年龄62.1岁）。采用诊断标准诊断SubCS， 1 mg地塞米松抑制试验（DST）后血清皮质醇水平大于50 nmol/L诊断SH。结果：分别有14例、13例和53例患者被诊断为SubCS、SH或无功能肾上腺皮质腺瘤（NF）。高血压的患病率在诊断中有显著差异（SubCS, 78.6%； SH, 84.6%； NE, 39.6%； P=0.002），而其他临床特征如年龄、性别或腰围没有差异。多因素分析显示，与NF患者相比，SH患者患高血压的风险增加了11.7倍（95%可信区间：1.9-72.7，P=0.009）， SubCS患者患高血压的风险增加了9.5倍（95%可信区间：1.9-48.3，P=0.007）。结论：我们证明了细微的皮质醇生成肿瘤，如SH和SubCS，是高血压的独立危险因素。1 mg DST的临界值可用于预测高血压的发展。
Objective: The purpose of our study was to clarify whether subtle cortisol-producing tumors, such as not only subclinical Cushing's syndrome (SubCS) but also subclinical hypercortisolism (SH), influence the prevalence of hypertension, since numerous basic research studies have noted that glucocorticoid excess influences blood pressure.Methods: 80 patients with adrenocortical adenomas (39 women and 41 men; mean age 62.1 years) were enrolled. SubCS was diagnosed using a diagnostic criteria, and SH was diagnosed as the presence of a serum cortisol level greater than 50 nmol/L following 1-mg dexamethasone suppression test (DST).Results: SubCS, SH, or non-functioning adrenocortical adenoma (NF) was diagnosed in 14, 13, or 53 patients, respectively. The prevalence of hypertension differed significantly among the diagnoses (SubCS, 78.6%; SH, 84.6%; NE 39.6%; P=0.002), whereas no differences in other clinical characteristics such as age, sex, or waist girth were observed. The patients with SH had an 11.7-fold increased risk (95% confidence interval: 1.9-72.7, P=0.009) and those with SubCS had a 9.5-fold increased risk (95% confidence interval: 1.9-48.3, P=0.007) for hypertension compared to those with NF using a multivariate analysis.Conclusion: We demonstrated that subtle cortisol-producing tumors, such as SH as well as SubCS, were an independent risk factor for hypertension. The cut-off value of the 1-mg DST would be appropriate to predict the development of hypertension.