Prevalence and postoperative changes of metabolic syndrome in patients with adrenocortical adenoma / 中国糖尿病杂志

ABSTRACT

Objective To investigate changes of metabolic syndrome (MS ) in patients with adrenocortical adenoma (ACA ). Methods Sixty‐five patients with aldosterone producing adenoma (APA) ,43 patients with cortisol‐secreting adenoma (CSA) and 24 patients with nonfunctional adrenal adenoma (NAA) were evaluated. Body Mass Index (BMI) ,blood pressure ,plasma lipid ,fasting and 2 h postprandial plasma glucose ,plasma and urinary aldosterone ,plasma potassium ,basic and upright plasma renin activity (PRA ) ,plasma and urinary cortisol ,plasma ACTH and plasma potassium ACA were examined and compared with those from 53 patients of essential hypertension (EH ) and 58 controls. Adrenalectomy was performed for all the patients with adrenocortical adenoma. The data after operation were compared with those before operation. Results (1) The prevalence of MS was 38.5% ,41.9% , 20.8% ,24.5% and 17.5% in the groups respectively. The prevalence of obesity/overweight was higher in CSA group than in the other groups. There were 44.6% patients with hyperglycemia in APA group ,and 48.8% in CSA group. The prevalence of hypertension was the highest in APA and EH group ,followed by CSA group ,NAA and control groups. There were 55.4% patients with lipid disturbance in APA group , and 46.5% in CSA group. (2 ) We divided all APA and CSA patients into groups with or without MS. The APA patients with MS had higher plasma aldosterone than those without MS. The CSA patients with MS had higher 0800 and 2400 plasma cortisol than those without MS. (3) After operation ,the plasma and urinary aldosterone were decreased and the plasma potassium was increased in APA patients. The 0800 ,2400 plasma cortisol and urinary cortisol were decreased and the 0800 plasma ACTH was increased in CSA patients. There were no significant differences in hormonal measurements of NAA patients before and after operation. (4 ) The prevalence of MS was 27.7% ,27.9% and 29.2% in three groups after operation. The systolic and diastolic blood pressures were decreased in APA patients after operation ,and the systolic blood pressure decreased in CSA patients. There was no significant difference in MS measurements of NAA patients before and after operation. Conclusions Our study indicates that patients with functional adrenocortical adenoma have a significantly higher prevalence of metabolic syndrome which is related to over secretion of adrenal cortex hormone. After operation ,accompanying normalization of hormonal secretion ,the condition of MS in functional adrenocortical adenoma patients is improved.