Department for Obesity, Reproductive and Metabolic Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Institute of Medical Statistics and Informatics, Belgrade, Serbia.
Clin Endocrinol (Oxf). 2018 Apr;88(4):541-548. doi: 10.1111/cen.13541. Epub 2018 Feb 5.
A high prevalence of insulin resistance (IR) has proven to manifest in patients with adrenal incidentalomas (AI). It has been demonstrated that an increase in IR is related to the size of tumourous masses; additionally, luteinizing hormone (LH)-dependent adrenal pathologies are well documented in patients with LH-responsive adrenal tumours occurring under conditions of physiologically elevated LH. We hypothesized that an association between LH and insulin might play a role in adrenal tumourigenesis and steroidogenesis.
The aim of our study was to investigate the association between LH and IR; adrenal tumour size (ATS) and IR; LH and cortisol after the 1 mg overnight dexamethasone test (1 mg DST); and ATS and 1 mg DST cortisol in AI patients. This was a case-control study conducted in the Clinic for Endocrinology, Diabetes and Metabolic Diseases in Belgrade, Serbia. The total study group consisted of 105 menopausal women: 75 AI patients [27 with nonfunctional AI (NAI) and 48 with (possible) autonomous cortisol secretion ((P)ACS)] and 30 age-, BMI-, LH- and menopause duration-matched healthy control (HC) women. To estimate IR, we used homeostasis model assessment (HOMA-IR).
Luteinizing hormone and ATS are in a significant positive correlation with HOMA-IR and 1 mg DST cortisol in menopausal patients with AI and (P)ACS.
Our data point to a possible cause-effect relationship between LH and insulin in patients with AI and (P)ACS adding to the body of evidence of their involvement in adrenal tumourigenesis and steroidogenesis.
大量研究证明，患有肾上腺意外瘤（AI）的患者通常存在胰岛素抵抗（IR）。IR 与肿瘤体积之间的关系已被证实；此外，在黄体生成素（LH）升高的情况下，发生 LH 反应性肾上腺肿瘤的患者中，LH 依赖性肾上腺病变已有充分的记录。我们假设 LH 和胰岛素之间的关联可能在肾上腺肿瘤发生和类固醇生成中起作用。
我们的研究旨在调查 LH 与 IR 之间的关联；LH 与 IR、肾上腺肿瘤大小（ATS）与 IR 之间的关系；LH 和皮质醇在 1mg 过夜地塞米松试验（1mgDST）后的关系；以及 AI 患者中 ATS 和 1mgDST 皮质醇之间的关系。这是在塞尔维亚贝尔格莱德内分泌、糖尿病和代谢疾病诊所进行的一项病例对照研究。总研究组包括 105 名绝经后妇女：75 名 AI 患者[27 名无功能性 AI（NAI）和 48 名可能自主皮质醇分泌（PACS）]和 30 名年龄、BMI、LH 和绝经持续时间匹配的健康对照（HC）妇女。为了估计 IR，我们使用了稳态模型评估（HOMA-IR）。
在患有 AI 和（P）ACS 的绝经后患者中，LH 和 ATS 与 HOMA-IR 和 1mgDST 皮质醇呈显著正相关。
我们的数据表明，LH 和胰岛素之间可能存在因果关系，这增加了它们在 AI 和（P）ACS 患者的肾上腺肿瘤发生和类固醇生成中的作用的证据。
