Sunada Naruhiko, Hanayama Yoshihisa, Yamamoto Koichiro, Nakano Yasuhiro, Nada Takahiro, Honda Hiroyuki, Hasegawa Kou, Hagiya Hideharu, Otsuka Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Endocr J. 2022 Apr 28;69(4):417-425. doi: 10.1507/endocrj.EJ21-0488. Epub 2021 Nov 3.
Urinary catecholamines (CAs) have been examined for the screening of pheochromocytomas. The decision to perform screening is based on symptoms suggesting secondary hypertension or hyperactivities of the sympathetic nervous system. To elucidate the usefulness of urinary fractions and ratios of CAs, 79 patients in whom 24-h excretions of urinary CAs including adrenaline (AD), noradrenaline (NA) and dopamine (DA) had been examined from 2015 until 2020 were retrospectively analyzed. There were no significant differences in urinary CA levels between two age groups, gender groups and two BMI groups. Patients with histories of preexisting hypertension and diabetes showed significantly higher levels of urinary NA excretion, and the urinary ratio of NA/DA was also increased in the patients with a history of hypertension. Heart rate (HR) was significantly correlated with the urinary ratio of NA/DA. Serum free thyroxine (FT4) concentration and ratio of FT4/thyrotropin (TSH) were correlated with the level of urinary AD. The levels of TSH and FT4/TSH showed negative and positive correlations, respectively, with the urinary NA/DA ratio. Thus, increases of HR are related to the enhanced conversion of DA to NA and increased thyroid hormones are involved in the increase in urinary AD and the conversion of DA to NA. History of lifestyle-related diseases and changes of HR and thyroid functions need to be considered for the evaluation of urinary CAs and their ratios.
尿儿茶酚胺（CAs）已被用于嗜铬细胞瘤的筛查。进行筛查的决定基于提示继发性高血压或交感神经系统功能亢进的症状。为了阐明尿儿茶酚胺各组分及其比值的用途，我们对2015年至2020年期间接受了包括肾上腺素（AD）、去甲肾上腺素（NA）和多巴胺（DA）在内的24小时尿儿茶酚胺排泄量检测的79例患者进行了回顾性分析。两个年龄组、性别组以及两个体重指数（BMI）组之间的尿儿茶酚胺水平无显著差异。有高血压和糖尿病病史的患者尿去甲肾上腺素排泄水平显著升高，有高血压病史的患者尿NA/DA比值也升高。心率（HR）与尿NA/DA比值显著相关。血清游离甲状腺素（FT4）浓度及FT4/促甲状腺激素（TSH）比值与尿肾上腺素水平相关。TSH水平以及FT4/TSH比值分别与尿NA/DA比值呈负相关和正相关。因此，心率增加与多巴胺向去甲肾上腺素的转化增强有关，甲状腺激素增加与尿肾上腺素增加以及多巴胺向去甲肾上腺素的转化有关。在评估尿儿茶酚胺及其比值时，需要考虑生活方式相关疾病史以及心率和甲状腺功能的变化。
