Chang Chia-Hui, Hu Ya-Hui, Tsai Yao-Chou, Wu Che-Hsiung, Wang Shuo-Meng, Lin Lian-Yu, Lin Yen-Hung, Satoh Fumitoshi, Wu Kwan-Dun, Wu Vin-Cent
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan.
Oncotarget. 2017 May 2;8(18):29984-29995. doi: 10.18632/oncotarget.16269.
The aim of this study was to show the effect of KCNJ5 mutational status on arterial stiffness in aldosterone-producing adenomas after adrenalectomy. Between February 2008 and January 2010, we prospectively enrolled 108 aldosterone-producing adenoma patients undergoing adrenalectomy. We conducted repeated measurements of pulse wave velocity at baseline, 6 months, and 12 months after adrenalectomy, grouped by KCNJ5 mutational status. Prognostic factors of arterial stiffness and risk for hypertension at 12 months after adrenalectomy were analyzed after propensity score matching in a 1:1 ratio. After matching for age, sex and body mass index, 88 patients were divided equally into KCNJ5-mutant and non-mutant groups. KCNJ5 mutational status was not an independent variable in either the generalized estimating equation model (p = 0.147) or the percentage change of brachial-ankle pulse wave velocity (p = 0.106). The generalized additive model smoothing plot showed that aldosterone-producing adenoma patients who carried the KCNJ5 mutation and were aged between 37 and 60 may have a hypertension recovery advantage. According to our observations during a 12-month follow-up after adrenalectomy, KCNJ5 mutational status was not associated with improvement in arterial stiffness.
本研究旨在探讨肾上腺切除术后，KCNJ5突变状态对醛固酮瘤患者动脉僵硬度的影响。2008年2月至2010年1月期间，我们前瞻性纳入了108例接受肾上腺切除术的醛固酮瘤患者。根据KCNJ5突变状态分组，在肾上腺切除术前、术后6个月和12个月重复测量脉搏波速度。在按1:1比例进行倾向评分匹配后，分析肾上腺切除术后12个月时动脉僵硬度的预后因素和高血压风险。在匹配年龄、性别和体重指数后，88例患者被平均分为KCNJ5突变组和非突变组。在广义估计方程模型（p = 0.147）或臂踝脉搏波速度变化百分比（p = 0.106）中，KCNJ5突变状态均不是独立变量。广义相加模型平滑图显示，携带KCNJ5突变且年龄在37至60岁之间的醛固酮瘤患者可能具有高血压恢复优势。根据我们在肾上腺切除术后12个月随访期间的观察，KCNJ5突变状态与动脉僵硬度改善无关。
