Parasiliti-Caprino Mirko, Obert Chiara, Lopez Chiara, Bollati Martina, Bioletto Fabio, Bima Chiara, Egalini Filippo, Berton Alessandro Maria, Prencipe Nunzia, Settanni Fabio, Gasco Valentina, Mengozzi Giulio, Ghigo Ezio, Maccario Mauro
Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy.
Clinical Biochemistry Laboratory, City of Health and Science University Hospital, 10126 Turin, Italy.
J Clin Med. 2021 May 4;10(9):1967. doi: 10.3390/jcm10091967.
No research has explored the role of catecholamine metabolites in the stratification of cardiovascular risk. We aimed to evaluate the relationship between urine metanephrines and cardiometabolic risk/complications. In this retrospective cross-sectional study, we collected the data of 1374 patients submitted to the evaluation of urine metanephrines at the City of Health and Science University Hospital of Turin between 2007 and 2015, mainly for investigating the suspicion of secondary hypertension or the secretion of an adrenal lesion. The univariate analysis showed associations between metanephrines and cardiometabolic variables/parameters, particularly considering noradrenaline metabolite. At univariate regression, normetanephrine was associated with hypertensive cardiomyopathy (OR = 1.18, 95% CI 1.11-1.25; < 0.001) and metabolic syndrome (OR = 1.11, 95% CI 1.03-1.20; = 0.004), while metanephrine was associated with hypertensive cardiomyopathy (OR = 1.23, 95% CI 1.06-1.43; = 0.006) and microalbuminuria (OR = 1.30, 95% CI 1.03-1.60; = 0.018). At multivariate regression, considering all major cardiovascular risk factors as possible confounders, normetanephrine retained a significant association with hypertensive cardiomyopathy (OR = 1.14, 95% CI 1.07-1.22; < 0.001) and metabolic syndrome (OR = 1.10, 95% CI 1.02-1.19; = 0.017). Moreover, metanephrine retained a significant association with the presence of hypertensive cardiomyopathy (OR = 1.18, 95% CI 1.01-1.41; = 0.049) and microalbuminuria (OR = 1.34, 95% CI 1.03-1.69; = 0.019). The study showed a strong relationship between metanephrines and cardiovascular complications/metabolic alterations. Individuals with high levels of these indirect markers of sympathetic activity should be carefully monitored, and they may benefit from an aggressive treatment to reduce the cardiometabolic risk.
尚无研究探讨儿茶酚胺代谢产物在心血管风险分层中的作用。我们旨在评估尿甲肾上腺素与心脏代谢风险/并发症之间的关系。在这项回顾性横断面研究中，我们收集了2007年至2015年间在都灵市健康与科学大学医院接受尿甲肾上腺素评估的1374例患者的数据，主要用于调查继发性高血压的疑似情况或肾上腺病变的分泌情况。单因素分析显示甲肾上腺素与心脏代谢变量/参数之间存在关联，特别是考虑去甲肾上腺素代谢产物时。在单因素回归分析中，去甲变肾上腺素与高血压性心肌病相关（OR = 1.18，95%CI 1.11 - 1.25；<0.001）和代谢综合征相关（OR = 1.11，95%CI 1.03 - 1.20；= 0.004），而甲肾上腺素与高血压性心肌病相关（OR = 1.23，95%CI 1.06 - 1.43；= 0.006）和微量白蛋白尿相关（OR = 1.30，95%CI 1.03 - 1.60；= 0.018）。在多因素回归分析中，将所有主要心血管危险因素视为可能的混杂因素，去甲变肾上腺素与高血压性心肌病仍保持显著关联（OR = 1.14，95%CI 1.07 - 1.22；<0.001）和代谢综合征（OR = 1.10，95%CI 1.02 - 1.19；= 0.017）。此外，甲肾上腺素与高血压性心肌病的存在仍保持显著关联（OR = 1.18，95%CI 1.01 - 1.41；= 0.049）和微量白蛋白尿（OR = 1.34，95%CI 1.03 - 1.69；= 0.019）。该研究表明甲肾上腺素与心血管并发症/代谢改变之间存在密切关系。这些交感神经活动间接标志物水平较高的个体应受到密切监测，并且他们可能受益于积极治疗以降低心脏代谢风险。
