医学临床研究
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医学临床研究  2021, Vol. 38 Issue (10): 1500-1503    DOI: 10.3969/j.issn.1671-7171.2021.10.017
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原发性醛固酮增多症患者糖代谢特点及其相关影响因素研究
黄素兰, 郭宁**, 梁莉, 葛良清, 张志翔, 罗立
湖南省常德市第一人民医院心血管内科,湖南 常德 415000
Characteristics of Glucose Metabolism and Related Factors in Patients with Primary Aldosteronism
HUANG Su-lan, GUO Ning, LIANG Li, et al
Department of Cardiovascular, the First People's Hospital of Changde,Changde Hunan 415000
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摘要 【目的】探讨原发性醛固酮增多症(primary aldosteronism,PA)患者发生糖代谢异常的相关因素。【方法】回顾性分析2015年1月至2019年12月本院心内科收治的195例首诊为PA患者(观察组)的临床资料,同时纳入195例原发性高血压患者作为对照组。比较两组患者血糖代谢指标、血脂水平、诊室血压和动态血压情况,应用多元线性回归分析肾素、醛固酮和醛固酮/肾素活性比值(ARR)对血糖代谢指标的影响。【结果】观察组患者高血压病程、体重指数(BMI)、糖代谢异常所占比例、空腹血糖(FPG)、糖化血红蛋白(HbAc1)、K、醛固酮、ARR均高于对照组,肾素水平和女性比例低于对照组患者,差异有统计学意义(P<0.05)。观察组患者诊室血压、24 h血压、白昼及夜间血压均高于对照组,夜间收缩压下降率低于对照组,差异有统计学意义(P<0.05)。PA肾上腺增生患者FPG及糖代谢异常、糖尿病所占比例均高于肾上腺腺瘤患者(P<0.05)。多元线性回归分析显示,FPG、HbAc1水平与醛固酮水平独立相关(P<0.05)。【结论】PA患者血糖水平高于PH患者,醛固酮水平与FPG、HbAc1升高独立相关。
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关键词 醛固酮增多症血糖/代谢影响因素分析    
Abstract:【Objective】To explore the related factors of abnormal glucose metabolism in patients with primary aldosteronism (PA). 【Methods】The clinical data of 195 patients with PA first diagnosed in the Department of Cardiology of our hospital from January 2015 to December 2019 (observation group) were analyzed retrospectively, and 195 patients with essential hypertension were included as the control group. The blood glucose metabolism indexes, blood lipid level, consulting room blood pressure and ambulatory blood pressure of the two groups were compared. The effects of renin, aldosterone and aldosterone/renin activity ratio (ARR) on blood glucose metabolism indexes were analyzed by multiple linear regression. 【Objective】The course of hypertension, body mass index (BMI), the proportion of abnormal glucose metabolism, fasting blood glucose (FPG), glycosylated hemoglobin (HbAc1), K, aldosterone and ARR in the observation group were higher than those in the control group, and the renin level and the proportion of women in the observation group were lower than those in the control group (P<0.05). The consulting room blood pressure, 24-hour blood pressure, daytime and nighttime blood pressure in the observation group were higher than those in the control group, and the decrease rate of nighttime systolic blood pressure was lower than that in the control group (P<0.05). The proportion of FPG and abnormal glucose metabolism and diabetes in patients with PA adrenal hyperplasia were higher than those in adrenal adenomas (P<0.05). Multiple linear regression analysis showed that FPG and HbAc1 levels were independently correlated with aldosterone levels (P<0.05). 【Conclusion】The blood glucose level in PA patients is higher than that in pH patients. The aldosterone level is independently related to the increase of FPG and HbAc1.
Key wordsHyperaldosteronism    Blood Glucose/ME    Root Cause Analysis
收稿日期: 2020-09-25     
中图分类号:  R586.24  
基金资助:湖南省卫生健康委科研计划项目资助(20200224);常德市科学技术局技术研究与开发资金项目(2020S025)
通讯作者: **E-mail:2238769857@qq.com   
引用本文:   
黄素兰, 郭宁, 梁莉, 葛良清, 张志翔, 罗立. 原发性醛固酮增多症患者糖代谢特点及其相关影响因素研究[J]. 医学临床研究, 2021, 38(10): 1500-1503.
HUANG Su-lan, GUO Ning, LIANG Li, et al. Characteristics of Glucose Metabolism and Related Factors in Patients with Primary Aldosteronism. JOURNAL OF CLINICAL RESEARCH, 2021, 38(10): 1500-1503.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.10.017     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I10/1500
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