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首页> 美国卫生研究院文献>Journal of the Endocrine Society >MON-215 Clinical Factors Associated with Insulin Secretion and Sensitivity in Patients with Primary Aldosteronism
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MON-215 Clinical Factors Associated with Insulin Secretion and Sensitivity in Patients with Primary Aldosteronism

机译：与原发性醛固酮患者胰岛素分泌和敏感性相关的MON-215临床因素

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Introduction: Primary aldosteronism (PA) is associated with an increased risk of impaired glucose tolerance or type 2 diabetes mellitus. Previous studies have reported that impaired insulin secretion and insulin sensitivity in PA may lead to impaired glucose tolerance. However, the relationship between PA and glucose tolerance, and the factor associated with these glucose metabolism abnormalities is not well understood. In particular, few studies have analyzed the association between aldosterone excess and insulin sensitivity or resistance after the adjustment for other clinical variables. In this study, we analyzed the associations between multiple clinical variables observed in PA and the indices of insulin sensitivity and resistance, using the result of 75 g oral glucose tolerance test (OGTT).Method: This was a retrospective observational study that analyzed the data of 646 patients with PA who underwent adrenal venous sampling and 75 g OGTT. The insulinogenic index and Matsuda index, indices of insulin secretion and sensitivity, respectively, were calculated from the results of a 75 g OGTT. Correlations between these indices and the multiple clinical variables were analyzed. In addition, we performed multiple regression analyses to identify the independent explanatory variables of these indices.Results: Insulinogenic index had positive correlations with the body mass index (BMI), alanine aminotransferase (ALT) level, triglyceride (TGL) level, and potassium level, and negative correlations with both age and plasma aldosterone concentration (PAC). In a multiple regression analysis, both the age (β = -0.231, p < 0.001) and potassium level (β = 0.175, p = 0.002) were selected as the independent explanatory factors. The Matsuda index had positive correlations with the PAC and cortisol level after a 1 mg dexamethasone suppression test (DST), and negative correlations with BMI, ALT level, TGL level, plasma renin activity (PRA), and potassium level. In a multiple regression analysis, BMI (β = -0.216, p < 0.001), ALT level (β = -0.290, p < 0.001), TGL level (β = -0.225, p < 0.001), the cortisol level after 1 mg DST (β = 0.124, p = 0.009), and PRA (β = -0.119, p = 0.019) were selected as the independent explanatory factors.Conclusion: In PA patients, older age and decreased potassium levels were associated with impaired insulin secretion. An increase in the variables associated with metabolic abnormalities such as BMI, ALT, and TGL were associated with decreased insulin sensitivity. In addition, we found that decreased PRA was associated with increased insulin sensitivity.
机译：介绍：原发性醛固酮增多症（PA）与糖耐量受损的风险增加相关或2型糖尿病。以前的研究报告，在PA胰岛素分泌受损和胰岛素敏感性可能导致糖耐量受损。然而，PA及糖耐量，并与这些糖代谢异常相关因素之间的关系还不是很清楚。特别是，一些研究已经分析了调整用于其它临床变量后醛固酮过量与胰岛素敏感性或抗性之间的关联。在这项研究中，我们分析了在PA观察在多个临床变量与胰岛素敏感性和耐药性的指标之间的关联，使用75g口服葡萄糖耐量试验（OGTT）。方法的结果是：这是一个回顾性观察研究，分析的数据646例PA谁接受肾上腺静脉采血和75g OGTT。的胰岛素产生指数和松田指数，胰岛素分泌和敏感性的指数，分别从在75克OGTT的结果计算。这些指数和多个临床变量之间的相关性进行了分析。此外，我们进行了多重回归分析，以确定这些indices.Results的独立变数的胰岛素产生指数曾与身体质量指数（BMI），谷丙转氨酶（ALT）水平，甘油三酯正相关（TGL）的水平，和钾水平和负相关与年龄和血浆醛固酮浓度（PAC）。在多重回归分析法，年龄（β= -0.231，P <0.001）和钾水平（β= 0.175，P = 0.002）被选定为独立的解释因素。松田指数与所述PAC和1毫克地塞米松抑制试验（DST）后皮质醇水平，并与BMI，ALT水平，TGL水平，血浆肾素活性（PRA）和钾水平负相关的正相关。在多重回归分析中，BMI（β= -0.216，P <0.001），ALT水平（β= -0.290，P <0.001），TGL水平（β= -0.225，P <0.001），1毫克后的皮质醇水平DST（β= 0.124，p = 0.009），和PRA（β= -0.119，p值= 0.019）被选定为独立说明因素。结论：在PA患者，年龄和降低的钾水平与胰岛素分泌受损相关联。与代谢异常如BMI，ALT和TGL关联的变量的增加，用胰岛素敏感性降低相关联。此外，我们发现，降低PRA与增加胰岛素的敏感性有关。

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