Bergthorsdottir Ragnhildur, Ragnarsson Oskar, Skrtic Stanko, Glad Camilla A M, Nilsson Staffan, Ross Ian Louis, Leonsson-Zachrisson Maria, Johannsson Gudmundur
Department of Endocrinology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
J Clin Endocrinol Metab. 2017 Nov 1;102(11):4264-4272. doi: 10.1210/jc.2017-01324.
Patients with Addison's disease (AD) have increased cardiovascular mortality.
To study visceral fat and conventional and exploratory cardiovascular risk factors in patients with AD.
A cross-sectional, single-center, case-control study.
Patients (n = 76; n = 51 women) with AD and 76 healthy control subjects were matched for sex, age, body mass index (BMI), and smoking habits.
The primary outcome variable was visceral abdominal adipose tissue (VAT) measured using computed tomography. Secondary outcome variables were prevalence of metabolic syndrome (MetS) and 92 biomarkers of cardiovascular disease.
The mean ± standard deviation age of all subjects was 53 ± 14 years; mean BMI, 25 ± 4 kg/m2; and mean duration of AD, 17 ± 12 years. The median (range) daily hydrocortisone dose was 30 mg (10 to 50 mg). Median (interquartile range) 24-hour urinary free cortisol excretion was increased in patients vs controls [359 nmol (193 to 601 nmol) vs 175 nmol (140 to 244 nmol); P < 0.001]. VAT did not differ between groups. After correction for multiple testing, 17 of the 92 studied biomarkers differed significantly between patients and control subjects. Inflammatory, proinflammatory, and proatherogenic risk biomarkers were increased in patients [fold change (FC), >1] and vasodilatory protective marker was decreased (FC, <1). Twenty-six patients (34%) vs 12 control subjects (16%) fulfilled the criteria for MetS (P = 0.01).
Despite higher cortisol exposure, VAT was not increased in patients with AD. The prevalence of MetS was increased and several biomarkers of cardiovascular disease were adversely affected in patients with AD.
艾迪生病(AD)患者心血管疾病死亡率增加。
研究AD患者的内脏脂肪以及传统和探索性心血管危险因素。
一项横断面、单中心病例对照研究。
76例AD患者(51例女性)和76例健康对照者,根据性别、年龄、体重指数(BMI)和吸烟习惯进行匹配。
主要观察变量是使用计算机断层扫描测量的腹部内脏脂肪组织(VAT)。次要观察变量是代谢综合征(MetS)的患病率和92种心血管疾病生物标志物。
所有受试者的平均年龄±标准差为53±14岁;平均BMI为25±4kg/m²;AD的平均病程为17±12年。氢化可的松每日剂量中位数(范围)为30mg(10至50mg)。患者24小时尿游离皮质醇排泄中位数(四分位间距)高于对照组[359nmol(193至601nmol)对175nmol(140至244nmol);P<0.001]。两组间VAT无差异。经过多重检验校正后,92种研究的生物标志物中有17种在患者和对照者之间存在显著差异。患者的炎症、促炎和促动脉粥样硬化风险生物标志物增加[倍数变化(FC),>1],血管舒张保护标志物降低(FC,<1)。26例患者(34%)与12例对照者(16%)符合MetS标准(P=0.01)。
尽管AD患者皮质醇暴露量较高,但VAT并未增加。AD患者MetS患病率增加,且多种心血管疾病生物标志物受到不利影响。