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无功能垂体大腺瘤患者的心血管风险和代谢综合征特征

Cardiovascular Risk and Metabolic Syndrome Characteristics in Patients with Nonfunctional Pituitary Macroadenoma.

作者信息

Vargas-Ortega Guadalupe, González-Virla Baldomero, Balcázar-Hernández Lourdes, Nieto-Guzmán Oriana, Garrido-Mendoza Ana Pamela, Flores-Maya Marco Antonio, Mendoza-Zubieta Victoria

机构信息

Endocrinology Service, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

出版信息

Int J Endocrinol. 2018 Aug 27;2018:2852710. doi: 10.1155/2018/2852710. eCollection 2018.

Abstract

CONTEXT

An elevated incidence of type 2 diabetes and cardiovascular disease (CVD) has been reported in patients with nonfunctional pituitary macroadenoma (NFPMA). There is no information about metabolic syndrome and cardiovascular risk in patients with NFPMA in our population.

OBJECTIVE

Analyze the metabolic syndrome (MetS) components and estimate cardiovascular risk in patients with NFPMA.

DESIGN AND SETTING

Retrospective study, at the tertiary care center.

PATIENTS AND METHODS

71 patients with NFPMA treated according to a preestablished multimodal protocol.

MAIN OUTCOME MEASURES

Prevalence of diabetes, hypertension, high cholesterol, obesity, and cardiovascular risk and its relationship with the clinical and biochemical characteristics.

RESULTS

The prevalence of diabetes, hypertension, high cholesterol, and obesity at diagnosis was 30%, 27%, 48%, and 85% and did not change upon the last visit. The prevalence of MetS changes from 54 to 48% ( = 0.001). NFPMA patients showed a significant increase risk for high total cholesterol (SMR 1.68, 95% CI 1.28-2.17, = 0.001) and diabetes (SMR 3.19, 95% CI 2.19-4.49, = 0.01). According to Globorisk, the male gender was an evidence of high CVD before (81% versus 18%, = 0.01) and after (72% versus 28%, = 0.01) multimodal treatment.

CONCLUSION

A high prevalence of cardiovascular and metabolic disease and a high cardiovascular risk were evidenced in patients with NFPMA, especially in men. Risk factors such as the personal history of hypertension and dyslipidemia could explain the foregoing, so the control and treatment of metabolic parameters and cardiovascular risk should be an integral part of the follow-up of these patients.

摘要

背景

据报道,无功能垂体大腺瘤(NFPMA)患者中2型糖尿病和心血管疾病(CVD)的发病率有所升高。在我们的人群中,尚无关于NFPMA患者代谢综合征和心血管风险的信息。

目的

分析NFPMA患者的代谢综合征(MetS)成分并评估心血管风险。

设计与地点

在三级医疗中心进行的回顾性研究。

患者与方法

71例根据既定多模式方案治疗的NFPMA患者。

主要观察指标

糖尿病、高血压、高胆固醇、肥胖症的患病率以及心血管风险及其与临床和生化特征的关系。

结果

诊断时糖尿病、高血压、高胆固醇和肥胖症的患病率分别为30%、27%、48%和85%,末次随访时无变化。MetS的患病率从54%降至48%(P = 0.001)。NFPMA患者的总胆固醇升高风险显著增加(标准化发病比[SMR] 1.68,95%置信区间[CI] 1.28 - 2.17,P = 0.001)和糖尿病风险显著增加(SMR 3.19,95% CI 2.19 - 4.49,P = 0.01)。根据全球心血管风险评估模型(Globorisk),男性在多模式治疗前(81%对18%,P = 0.01)和治疗后(72%对28%,P = 0.01)均显示出高心血管疾病风险。

结论

NFPMA患者存在心血管和代谢疾病的高患病率以及高心血管风险,尤其是男性。高血压和血脂异常等危险因素可以解释上述情况,因此代谢参数和心血管风险的控制与治疗应成为这些患者随访的重要组成部分。

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The chronic syndromes after previous treatment of pituitary tumours.垂体瘤既往治疗后的慢性综合征。
Nat Rev Endocrinol. 2016 Sep;12(9):547-56. doi: 10.1038/nrendo.2016.84. Epub 2016 Jun 3.

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