Sumbul Hilmi Erdem, Koc Ayse Selcan
Department of Internal Medicine, University of Health Sciences-Adana Health Practice and Research Center, Adana, Turkey.
Department of Radiology, University of Health Sciences-Adana Health Practice and Research Center, Dr. Mithat Özsan Bulvarı Kışla Mah, 4522 Sok, No: 1 Yüreğir, Adana, Turkey.
High Blood Press Cardiovasc Prev. 2019 Feb;26(1):69-75. doi: 10.1007/s40292-018-0293-9. Epub 2018 Dec 7.
There are conflicting results regarding the frequency of hypertension (HT) and values of related parameters in patients with acromegaly.
We aimed to determine the frequency of HT and values of its associated parameters in patients with acromegaly.
57 patients with newly diagnosed acromegaly were included in this study. Renal ultrasonography (US) was performed in addition to routine evaluation of acromegaly. Renal resistive index (RRI), renal pulsatility index (RPI), and accelerated time were measured using Doppler US.
Hypertension was detected in 16 patients (28.1%) with newly diagnosed acromegaly. Serum triglyceride, TSH, growth hormone, and insulin growth factor 1 levels were higher and HDL levels were lower in acromegaly patients with HT. RRI and RPI values were found to be higher in acromegaly patients with HT. In logistic regression analysis, only the RRI value was found to be independently related to the presence of HT. Based on this analysis, it was determined that the frequency of HT increases 2.99 times for each increase in RRI of 0.05 units. When ROC analysis was performed, it was found that the area under the ROC curve was 0.781. In the same analysis, when the cutoff value for RRI was taken to be 0.70, the development of HT in acromegaly patients was determined with 75% sensitivity and 78% specificity.
In patients with newly diagnosed acromegaly, HT frequency was significantly increased and it was independently associated with the RRI value. Therefore, these patients should be closely monitored for HT-the most frequent and important cardiovascular risk factor-and treated before they develop target organ damage.
关于肢端肥大症患者高血压（HT）的发生率及其相关参数的值，存在相互矛盾的结果。
我们旨在确定肢端肥大症患者HT的发生率及其相关参数的值。
本研究纳入了57例新诊断的肢端肥大症患者。除了对肢端肥大症进行常规评估外，还进行了肾脏超声检查（US）。使用多普勒超声测量肾阻力指数（RRI）、肾搏动指数（RPI）和加速时间。
在16例（28.1%）新诊断的肢端肥大症患者中检测到高血压。HT肢端肥大症患者的血清甘油三酯、促甲状腺激素、生长激素和胰岛素生长因子1水平较高，高密度脂蛋白水平较低。HT肢端肥大症患者的RRI和RPI值较高。在逻辑回归分析中，仅发现RRI值与HT的存在独立相关。基于该分析，确定RRI每增加0.05个单位，HT的发生率增加2.99倍。进行ROC分析时，发现ROC曲线下面积为0.781。在同一分析中，当将RRI的临界值设为0.70时，肢端肥大症患者HT的发生以75%的敏感性和78%的特异性确定。
在新诊断的肢端肥大症患者中，HT发生率显著增加，且与RRI值独立相关。因此，应密切监测这些患者是否发生HT（最常见且重要的心血管危险因素），并在发生靶器官损害之前进行治疗。
