代谢综合征在原发性醛固酮增多症中的患病特征

摘要

Objective To assess the characteristics of the metabolic syndrome (MS) in patients rnwith primary aldosteronism by analyzing the clinical information of 62 patients with primary aldosteronism rn(PA) ,and to explore the possible mechanism of the effects of aldosterone on the metabolism. Methods rnWe analysed all the 62 patients with PA,60 patients with essential hypertension ( EH ). Results 1. The rnprevalence of MS in PA group was higher than in EH group,distribution of single components of the metarnbolic syndrome other than hypertension and obesity showed a higher prevalence of hyportriglycerids,lowerrning high-density lipoprotein cholesterol(HDL-C) and hyperglycemia in PA than in EH. 2. The correlation rnstudy show that aldosterone was associated with BMI, plasma and uremia potassium. The aldosterone renin rnratio was associated with TC and LDL-C. Conclusions 1. The primary aldosteronism was closely associatrned with metabolic syndrome, and the metabolic abnormalities including hyperglycemia and dyslipidemia rnwas more common in patients with PA. 2. The effects of aldosterone on the metabolinism was associated rnwith the activity of the rennin, and the aldosterone renin ratio was better than the plasma aldosterone level rnto reflect the effects on metabolism..%目的 通过分析62例原发性醛同酮增多症(原醛症)患者的临床资料,了解代谢综合征在原醛症患者中的发病及临床特征,并初步探讨醛固酮对代谢影响及可能的机制.方法 收集62例原醛症患者和60例年龄和体质指数相匹配的原发性高血压患者的临床资料.结果 1.原醛症患者中代谢综合征的患病率高于原发性高血压对照组,且在代谢综合征中除高血压和肥胖外、血脂异常和糖调节异常的患病率也高于对照组.2.相关分析显示卧位血浆醛固酮水平与体质指数、腰围、血钾及尿钾水平明显负相关,立位醛同酮水平与体质指数显著负相关,醛同酮/肾素比值与总胆同醇、低密度脂蛋门胆固醇水平明显负相关.结论 1.原醛症与代谢综合征密切相关,其血糖和血脂异常表现尤其突出;2.醛固酮对糖脂代谢的影响与肾素活性有关,血浆醛周酮/肾素比值较血浆醛固酮水平能更好反映醛固酬对代谢的影响.