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目的:比较原发性醛固酮增多症与原发性高血压的糖脂代谢特征。方法:431例已确诊的原发性醛固酮增多症(PA)患者,其中256例行肾上腺静脉取血,分为原醛单侧组(LPA,n=147)、原醛双侧组(NLPA,n=109)。同时入选与性别、年龄、及高血压病程相匹配的同期住院原发性高血压(EH)患者200例为对照组。收集各组的临床资料和生化指标,计算PA检出率并分析糖脂代谢特点。结果:(1)PA检出率为10.54%(431/4100);(2)体重指数、腰围PA组较EH组高;(3)血三酰甘油LPA组高于NLPA组和EH组,高密度脂蛋白NLPA较EH组低;(4)血糖水平、血胰岛素各点及胰岛素抵抗指数均PA组高于EH组,且NLPA组高于LPA组;(5)体重指数可增加LPA组危险性(OR值=2.24,P=0.024);(6)三酰甘油与尿醛固酮呈显著正相关,体重指数与卧位醛固酮水平呈正相关,各点胰岛素水平和胰岛素抵抗指数均与醛固酮水平和尿醛固酮呈显著正相关。结论:与EH患者相比,PA糖脂代谢异常程度重,其中LPA脂代谢以及NLPA组糖代谢异常更为严重。
Objective: To compare the characteristics of glycometabolism in essential aldosteronism and essential hypertension. Methods: A total of 431 patients with confirmed primary aldosteronism (PA) were enrolled. Among them, 256 patients received adrenalectomy and were divided into two groups: untreated group (LPA, n = 147) n = 109). At the same time selected 200 cases of hospitalized patients with essential hypertension (EH) in the same period with gender, age, and duration of hypertension as the control group. The clinical data and biochemical indexes of each group were collected, the detection rate of PA was calculated and the characteristics of glucose and lipid metabolism were analyzed. Results: (1) PA detection rate was 10.54% (431/4100); (2) body mass index, waist circumference PA group was higher than EH group; (3) blood triglyceride LPA group was higher than NLPA group and EH group (4) The levels of blood glucose, blood insulin and insulin resistance index in PA group were higher than those in EH group and NLPA group was higher than LPA group; (5) Body mass index increased the risk of LPA group (OR = 2.24, P = 0.024). (6) There was a significant positive correlation between triglyceride and urinary aldosterone, body mass index and aldosteronism level were positively correlated, each point of insulin and insulin resistance index were aldosterone levels and urine aldosterone There was a significant positive correlation. CONCLUSION: Compared with EH patients, the degree of dyslipidemia of PA is severe, and the LPA lipid metabolism and the abnormal glucose metabolism of NLPA group are more serious.