Spyroglou Ariadni, Adolf Christian, Hahner Stefanie, Quinkler Marcus, Ladurner Roland, Reincke Martin, Beuschlein Felix
Medizinische Klinik und Poliklinik IV, Endocrine Research Unit, Klinikum der Universität München, LMU, Munich, Germany.
Medizinische Klinik und Poliklinik I, Universitätsklinikum Würzburg, Würzburg, Germany.
Horm Metab Res. 2017 Mar;49(3):208-213. doi: 10.1055/s-0042-124189. Epub 2017 Feb 21.
Catecholamine excess from pheochromocytoma results in cardiovascular symptoms such as arterial hypertension and tachycardia and induces metabolic alterations including glucose intolerance and increase in resting metabolic rate. The objective of our study was to investigate the effect of surgical cure of pheochromocytoma on body-mass-index and the correlation of body-mass-index changes to preoperative endocrine parameters. Pheochromocytoma patients from the Munich ENSAT Registry were matched (1:2) for age and gender to patients from the German Conn's Registry, who had undergone surgery for aldosterone-producing-adenomas. Thereby, 43 pheochromocytoma patients (17 males/26 females) and 86 aldosterone-producing-adenoma patients were analyzed for body-mass-index, blood pressure, and catecholamine levels before and one year after adrenalectomy. Seventy-four percent of pheochromocytoma patients were hypertensive preoperatively and 48% one year postoperatively. Systolic blood pressure did not differ significantly in pre- and postoperative measurements whereas diastolic blood pressure was significantly reduced over time. Moreover, pheochromocytoma patients gained body weight (p<0.001) one year following adrenalectomy accompanied by significant increases in body-mass-index, whereas aldosterone-producing adenoma patients displayed a slight weight loss. Despite weight gain, diagnosis of diabetes mellitus dropped from 9 of 43 investigated pheochromocytoma patients at baseline to 4 at follow-up. A significant correlation between body-mass-index changes to the preoperative catecholamine levels was found only for urinary normetanephrines. These data suggest that normalization of chronic catecholamine excess by adrenalectomy is associated with an increase in body-mass-index, which is more pronounced in patients with high preoperative levels of urinary normetanephrines.
嗜铬细胞瘤导致的儿茶酚胺过量会引发心血管症状，如动脉高血压和心动过速，并引起代谢改变，包括葡萄糖耐量异常和静息代谢率增加。我们研究的目的是调查嗜铬细胞瘤手术治愈对体重指数的影响以及体重指数变化与术前内分泌参数的相关性。将慕尼黑ENSAT登记处的嗜铬细胞瘤患者按年龄和性别（1:2）与德国Conn登记处接受醛固酮瘤手术的患者进行匹配。由此，对43例嗜铬细胞瘤患者（17例男性/26例女性）和86例醛固酮瘤患者在肾上腺切除术前及术后一年的体重指数、血压和儿茶酚胺水平进行了分析。74%的嗜铬细胞瘤患者术前高血压，术后一年为48%。收缩压术前和术后测量无显著差异，而舒张压随时间显著降低。此外，嗜铬细胞瘤患者在肾上腺切除术后一年体重增加（p<0.001），体重指数显著升高，而醛固酮瘤患者体重略有下降。尽管体重增加，但糖尿病的诊断从43例接受调查的嗜铬细胞瘤患者基线时的9例降至随访时的4例。仅发现尿去甲变肾上腺素的体重指数变化与术前儿茶酚胺水平之间存在显著相关性。这些数据表明，通过肾上腺切除术使慢性儿茶酚胺过量恢复正常与体重指数增加有关，这在术前尿去甲变肾上腺素水平高的患者中更为明显。
