ABSTRACT
One hundred and forty-five patients with primary aldosteronism (PA) admitted from 2006 to 2013 were enrolled in the study. The diagnosis of PA was confirmed by upright furosemide test and all patients met the following criteria: ① round-or oval-shaped lesion of low density with diameter>1 cm in one adrenal gland shown in contrast CT scan; ② no lesion or abnormality in contralateral adrenal gland; ③serum potassium level<3.5 mmol/L. Of 145 patients, 106 underwent total adrenalectomy, 36 partial adrenalectomy and 3 tumor enucleation. Serum potassium was (2.75±0.55) mmol/L before and (4.03±0.46) after surgery. Potassium was normalized after treatment in 141 cases (97.2％) with correction or improvement in hypertension; 4 patients (2.8％) remained hypokalemic and received spironolactone. Patients with normalized potassium were followed up for a medium period of 74 months (22—103 months), of whom 32 (22.7％) dropped off; the remaining 109 (77.3％) patients did not have hypokalemia. Multivariate linear correlation analysis showed that serum potassium level was negatively correlated with tumor diameter (r=?0.273,95％ CI:?0.086—?0.564, P=0.026) and basal serum aldosterone level (r=?0.261,95％ CI:?0.047— ?0.514, P=0.036). In PA patients with unilateral adrenal macroadenoma and hypokalemia, satisfactory surgical resolution can be achieved without adrenal venous sampling in majority of patients.
ABSTRACT
Dipeptidyl peptidase 4 (DPP-4) inhibitors are novel oral hypoglycemic agents, which have been used to inhibit degradation of endogenously released glucagon-like peptide-1 ( GLP-1 ) via inhibiting DPP-4 activity, consequently increasing level of GLP-1 in circulation, enhancing the effect of incretin hormone, and finally leading to improve glucose control. Meta-analysis showed that DPP-4 inhibitors exhibit better glucose-lowering effect in Asians compared with that in Caucasian. The racial differences of hypoglycemic effect could be mainly ascribed to the differences in the frequency of pancreatic-related gene mutations, the severity ofβ-cell dysfunction, the level of GLP-1, and the intake of carbohydrates in patients with diabetes mellitus.
