ABSTRACT
adrenocorticalcarcinoma；cortisolhypersecretion；hypokalemia；prognosis@#【Objective】To analyze the prognostic determinants of adreno cortical carcinoma（ACC）inadults.【Methods】Alladult patients who were admitted to SunYat-sen Memorial Hospital，SunYat-sen University from December 2011 to March 2017 and pathologically diagnosed ACC were included in this study.Thec linical data and preoperative laboratory examinations of those patients were analyzed retrospectively. Overall survival or disease-free survival was calculated and survivalcurves were plotted by Kaplan-Meier and compared by log-rank test. Harzardratios（HRs） with their 95% confidenceintervals（CIs） were calculated by univariate and multivariate Coxregression model.【Results】The study included 20 adult patients with ACC， with a median follow-up of 13months （6~73 months）. The mean survival time of those patients was 49.2 months（6~73months），with a 1-year survival rate of 70.0%. The results of multivariate Coxregression analysis revealed that the presense of cortisol hypersecretion（HR=23.60，95%CI：2.49-223.79，P=0.006） and hypokalemia（HR=23.60，95%CI：2.49-223.79，P=0.006）were predictors of poorprognosis of ACC. Moreover，in 18 patients with completely resected ACC，the presense of hypokalemia resulted in a worse disease-free survival.【Conclusion】The presense of cortisol hypersecretion and hypokalemiaare independent risk factors associated with poorprognosis of ACC in adults.
ABSTRACT
<p><b>OBJECTIVE</b>To compare plasma concentrations of biomarkers of endothelial dysfunction between patients with primary aldosteronism (PA) and essential hypertension (EH), and to determine whether elevated levels of these biomarkers could predict development of early organ damage.</p><p><b>METHODS</b>Thirty-six PA patients and 39 EH patients matched for age, sex, blood pressure and duration of hypertension were included in this study. Plasma levels of biomarkers reflecting endothelial dysfunction (von Willebrand factor, vWF; soluble intercellular adhesion molecule 1, sICAM-1; and oxidized low density lipoprotein, ox-LDL) were detected and compared between PA and EH patients. Left ventricular mass index (LVMI) determined by echocardiography, 24-hour urinary protein quantitative determination and urinary albumin excretion rate (UAER) were analyzed to evaluate early organ damage. Left ventricular hypertrophy was defined as LVMI > 125 g/m(2) in men and > 120 g/m(2) in women, and UAER between 20 µg/min and 200 µg/min was defined as microalbuminuria.</p><p><b>RESULTS</b>vWF [(122.3 ± 53.8)% vs. (113.1 ± 68.3)%], sICAM-1 [(401.0 ± 74.1) µg/L vs. (300.9 ± 87.0) µg/L], ox-LDL [(13.6 ± 10.0) U/L vs. (8.1 ± 5.9) U/L], LVMI [(124.7 ± 33.6) g/m(2) vs. (109.1 ± 25.7) g/m(2)], 24-hour urinary protein quantitation [24 h UPQ, (0.17 ± 0.10) g vs. (0.09 ± 0.04) g] and UAER [(25.9 ± 7.7) µg/min vs. (9.7 ± 5.9) µg/min] were significantly higher in PA group than in EH group (all P < 0.05). Elevated plasma vWF, sICAM-1 levels and plasma aldosterone concentration independently predicted microalbuminuria. Whereas, elevated plasma vWF and ox-LDL levels, plasma aldosterone concentration and systolic blood pressure independently predicted left ventricular hypertrophy.</p><p><b>CONCLUSION</b>Patients with PA have severer endothelial dysfunction reflected by multiple biomarkers and earlier organ damage than patients with EH, and plasma aldosterone concentration and multiple endothelial dysfunction biomarkers could independently predict early organ damage.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Albuminuria , Biomarkers , Metabolism , Hyperaldosteronism , Metabolism , Pathology , Hypertension , Metabolism , Pathology , Lipoproteins, LDL , Blood , von Willebrand Factor , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of compound Danshen Dripping Pill (CDDP) on peripheral arterial intima-media thickness (IMT) in patients newly diagnosed as type 2 diabetes mellitus.</p><p><b>METHODS</b>One hundred and eight patients were equally randomized into 3 groups, in addition to the basic hypoglycemic, hypotensive and lipid-regulation treatment, they were administered orally with aspirin (0.1 g, once daily), vitamin E (0.1 g, twice daily) and CDDP (10 pills, thrice daily) for 18 months, respectively. The conventional cardiovascular risk factors, such as hyperglycemia, lipids profile, and homeostasis model assessment of insulin resistance (HOMA-IR) as well as ultrasound measurement of peripheral arterial IMT before and after treatment were compared.</p><p><b>RESULTS</b>In the group treated with CDDP after treatment, the levels of HbA1c, serum total cholesterol and low density lipoprotein cholesterol (LDL-C) were significantly lower (all P<0.01), HOMA-IR was higher than those in the other two groups; while IMTs of carotid, iliac and femoral arteries were insignificantly different among them (P>0.05); however, the increment of carotid IMT in the CDDP treated group was less than that in the aspirin treated group (P<0.05), and that of femoral IMT was less than both the aspirin and vitamin E treated groups (P<0.05).</p><p><b>CONCLUSION</b>For the patients with newly diagnosed type 2 diabetes, additional administration of CDDP to the conventional treatment could exert beneficial effects on blood glucose controling, and lipid profile improvement and delay of arterial intima-media proliferation.</p>