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上腺腺瘤患者的功能:单中心回顾性队列研究
Leili Rahimi1, Annop Kittithaworn1, Raul Gregg Garcia1
1Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
The Journal of clinical endocrinology and metabolism
|December 29, 2023
概括
轻度自主皮质醇分泌 (MACS) 和非功能上腺腺瘤 (NFA) 会增加慢性病 (CKD) 的风险. 上腺切除术改善了这些患者的功能 (eGFR),特别是年轻患者,基线 eGFR较低.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學.
- 手术瘤学手术瘤学
背景情况:
- 患有非功能性上腺瘤 (NFA) 和轻度自主皮质醇分泌 (MACS) 的患者患慢性病 (CKD) 的风险增加.
- 在这些患者中,导致CKD的特定因素在很大程度上是未知的.
- 了解这些因素对于主动管理和预防策略至关重要.
研究的目的:
- 在NFA和MACS患者中识别与慢性病 (CKD) 相关的因素.
- 评估上腺切除术对本患者队列功能的影响.
- 提供关于上腺功能与脏健康之间的关系的见解.
主要方法:
- 一项单中心队列研究包括在1999年至2020年期间被诊断患有NFA或MACS的患者.
- 轻度自主皮质醇分泌 (MACS) 是通过德甲后抑制试验 (DST) 的皮质醇水平来定义的.
- 多变量分析评估了诸如年龄,高血压和DST等因素对估计的膜过率 (eGFR) 的结果,包括上腺切除术后的变化.
主要成果:
- 与NFA患者相比,MACS患者在诊断时表现出较低的eGFR.
- 高龄,高血压和较高的DST皮质醇水平独立地与降低的eGFR相关.
- 上腺切除术导致eGFR显著改善,持续至手术后3.5年,特别是在手术前eGFR较低的年轻患者中.
结论:
- 德甲抑制试验 (DST) 皮质醇水平是上腺腺瘤患者功能下降的独立风险因素.
- 上腺切除术提供治疗效益,改善MACS和NFA患者的功能.
- 针对性上腺切除术在年轻的患者中,具有先前存在的较低的EGFR可能会产生最实质性的恢复.
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