Imga Narin Nasıroglu, Elalmıs Ozgul Ucar, Tuna Mazhar Muslum, Dogan Bercem Aycıcek, Sahın Deniz, Gursoy Tugba, Yalcın Yavuz, Berker Dilek, Guler Serdar
Department of Endocrinology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Kaohsiung J Med Sci. 2017 Jun;33(6):295-301. doi: 10.1016/j.kjms.2017.04.002. Epub 2017 May 11.
Adrenal incidentalomas (AIs) are usually discovered incidentally after imaging unrelated to adrenal glands. We aimed to evaluate standard risk factors for systemic atherosclerosis and echocardiographic changes in patients with nonfunctioning AIs and compare them with normal subjects. We evaluated 70 patients diagnosed with AIs and 51 healthy controls. Mean levels were determined for HbA1c, LDL, uric acid, fasting plasma insulin, HOMA, and neutrophil-to-lymphocyte ratio (NLR), and these values were found to be significantly higher in the patients than the controls. The mean left atrial diameter, interventricular septum thickness, posterior wall thickness, left ventricular mass, E-wave deceleration time, isovolumetric relaxation time, and the median ratio of the early transmittal flow velocity to the early diastolic tissue velocity (E/Em) were higher in patients with AIs compared to controls. The mitral annular early diastolic velocity was lower in patients with AIs. The mean aortic diastolic diameter, stiffness index (SI), and aortic strain were higher, and aortic distensibility was lower in the patients. The mean right ventricular diameter, right atrial major-axis diameter, and right atrial minor-axis diameter were statistically higher in the patient group than the controls. A negative correlation was found between the NLR and aortic strain and aortic distensibility, while a positive correction was found between the NLR and SI. We found altered left ventricular (LV) and right ventricular (RV) echocardiographic findings in patients with AIs without known cardiovascular disease. Aortic stiffness was also increased. These changes may be related to an increase in cardiovascular risk factors in AI patients.
肾上腺偶发瘤（AIs）通常是在与肾上腺无关的影像学检查后偶然发现的。我们旨在评估无功能肾上腺偶发瘤患者全身动脉粥样硬化的标准危险因素和超声心动图变化，并将其与正常受试者进行比较。我们评估了70例被诊断为肾上腺偶发瘤的患者和51名健康对照者。测定了糖化血红蛋白（HbA1c）、低密度脂蛋白（LDL）、尿酸、空腹血浆胰岛素、稳态模型评估法（HOMA）以及中性粒细胞与淋巴细胞比值（NLR）的平均水平，发现这些值在患者中显著高于对照组。与对照组相比，肾上腺偶发瘤患者的平均左心房直径、室间隔厚度、后壁厚度、左心室质量、E波减速时间、等容舒张时间以及早期经传输血流速度与早期舒张期组织速度的中位数比值（E/Em）更高。肾上腺偶发瘤患者的二尖瓣环早期舒张速度较低。患者的平均主动脉舒张直径、硬度指数（SI）和主动脉应变较高，而主动脉扩张性较低。患者组的平均右心室直径、右心房长轴直径和右心房短轴直径在统计学上高于对照组。发现NLR与主动脉应变和主动脉扩张性之间呈负相关，而NLR与SI之间呈正相关。我们发现，在无已知心血管疾病的肾上腺偶发瘤患者中，左心室（LV）和右心室（RV）的超声心动图表现发生了改变。主动脉僵硬度也增加了。这些变化可能与肾上腺偶发瘤患者心血管危险因素的增加有关。
