Erbil Yesim, Ozbey Nese, Barbaros Umut, Unalp Haluk Recai, Salmaslioglu Artur, Ozarmagan Selçuk
Department of General Surgery, Istanbul University Medical Faculty, 34340, Capa, Istanbul, Turkey.
World J Surg. 2009 Oct;33(10):2099-105. doi: 10.1007/s00268-009-0178-0.
It is not clear whether nonfunctional adrenal incidentaloma (NFA) increases the risk of atherosclerosis and metabolic syndrome or whether this type of adrenal tumor has been found more frequently in patients with cardiometabolic risk factors. We aimed to determine the effects of NFA on cardiometabolic risk factors and endothelial function and to compare the patients with a 1:1 cardiometabolic risk factor matched control group.
Thirty-five patients with NFA were studied, and 35 body mass index-, age-, and sex-matched subjects were regarded as group 2 controls. Thirty-five cardiometabolic risk factors-matched subjects were then regarded as group 3 controls.
Patients with NFA had significantly lower flow-mediated dilation (FMD)-a parameter for endothelial function-measurements compared with groups 2 and 3 (7.1 +/- 2.9% vs. 12.9 +/- 3.8% and 13.5 +/- 4.5%; P < 0.02). Frequency of metabolic syndrome was also significantly higher in NFA patients than in control groups 2 and 3 (31.4, 5.7, and 20.0%, respectively; P < 0.05). Age (Odds Ratio [OR] = 2.9), total cholesterol (OR = 2.3), and presence of adrenal incidentaloma (OR = 10) were significant independent predictors of lower FMD (P < 0.05 for all).
Patients with NFA have increased prevalence of metabolic syndrome and impaired endothelial function compared with 1:1 cardiometabolic risk factor-matched controls.
目前尚不清楚无功能肾上腺偶发瘤（NFA）是否会增加动脉粥样硬化和代谢综合征的风险，或者这种类型的肾上腺肿瘤是否在具有心脏代谢危险因素的患者中更频繁地被发现。我们旨在确定NFA对心脏代谢危险因素和内皮功能的影响，并将患者与按1:1比例匹配心脏代谢危险因素的对照组进行比较。
对35例NFA患者进行研究，35例体重指数、年龄和性别匹配的受试者被视为第2组对照。然后，35例心脏代谢危险因素匹配的受试者被视为第3组对照。
与第2组和第3组相比，NFA患者的血流介导的血管舒张（FMD）（内皮功能参数）测量值显著降低（分别为7.1±2.9% 、12.9±3.8%和13.5±4.5%；P<0.02）。NFA患者代谢综合征的发生率也显著高于第2组和第3组对照组（分别为31.4%、5.7%和20.0%；P<0.05）。年龄（优势比[OR]=2.9）、总胆固醇（OR=2.3）和肾上腺偶发瘤的存在（OR=10）是FMD降低的显著独立预测因素（均P<0.05）。
与按1:1比例匹配心脏代谢危险因素的对照组相比，NFA患者代谢综合征的患病率增加，内皮功能受损。
