代谢综合征是下丘脑功能障碍成人常见的共病。

Metabolic syndrome as a common comorbidity in adults with hypothalamic dysfunction.

机构信息

Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, The Translational Medicine Center of Peking Union Medical College Hospital (PUMCH), PUMCH, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.

Key Laboratory of Endocrinology of National Health Commission of the People's Republic of China, The Translational Medicine Center of Peking Union Medical College Hospital (PUMCH), PUMCH, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Oct 13;13:973299. doi: 10.3389/fendo.2022.973299. eCollection 2022.

DOI:10.3389/fendo.2022.973299

PMID:36313753

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9606337/

Abstract

OBJECTIVE

Hypothalamic dysfunction (HD) results in various endocrine disorders and is associated with an increased risk of metabolic comorbidities. This study aimed to analyze the clinical characteristics and metabolic abnormalities of adults with HD of various causes.

METHODS

This study retrospectively reviewed adults with HD treated at our center between August 1989 and October 2020. Metabolic characteristics of patients were compared to those of age-, sex-matched lean, and body mass index (BMI)-matched controls.

RESULTS

Temperature dysregulation (61.0%) was the most common hypothalamic physiological dysfunction. At least one anterior pituitary hormone deficiency was observed in 50 patients (84.7%), with hypogonadotropic hypogonadism being the most frequently observed. Metabolic syndrome was confirmed in 31 patients (52.5%) and was significantly more prevalent in those with panhypopituitarism or overweight/obesity. Metabolic syndrome (MetS) was significantly more common in patients with HD than in both lean and BMI-matched controls (P < 0.001 and P = 0.030, respectively). Considering the components of MetS, elevated fasting glucose levels were significantly more common in patients with HD than in BMI-matched controls (P = 0.029). Overweight/obesity and panhypopituitarism were significant risk factors for MetS in the multivariate analysis on patients with HD. Moreover, in the multivariate analysis on patients and BMI-matched control, HD was a significant risk factor of MetS (P=0.035, OR 2.919) after adjusted for age, sex and BMI.

CONCLUSIONS

Temperature dysregulation and hypogonadotropic hypogonadism are the most common physiological and endocrine dysfunctions, respectively. MetS and unfavorable metabolic profiles were prevalent in adults with HD. HD was a significant risk factor of MetS after adjusted for BMI.

摘要

目的

下丘脑功能障碍（HD）可导致各种内分泌紊乱，并与代谢合并症的风险增加相关。本研究旨在分析不同病因成人 HD 的临床特征和代谢异常。

方法

本研究回顾性分析了 1989 年 8 月至 2020 年 10 月在我中心治疗的 HD 成人患者。将患者的代谢特征与年龄、性别匹配的瘦人和体重指数（BMI）匹配的对照组进行比较。

结果

体温调节障碍（61.0%）是最常见的下丘脑生理功能障碍。50 名患者（84.7%）至少存在一种垂体前叶激素缺乏，其中最常见的是促性腺激素释放激素缺乏。31 名患者（52.5%）确诊为代谢综合征，且在全垂体功能减退或超重/肥胖患者中更为常见。与瘦人和 BMI 匹配的对照组相比，HD 患者的代谢综合征（MetS）更为常见（P<0.001 和 P=0.030）。考虑到 MetS 的组成部分，与 BMI 匹配的对照组相比，HD 患者的空腹血糖水平升高更为常见（P=0.029）。超重/肥胖和全垂体功能减退是 HD 患者多变量分析中 MetS 的显著危险因素。此外，在对患者和 BMI 匹配的对照组进行多变量分析时，调整年龄、性别和 BMI 后，HD 是 MetS 的显著危险因素（P=0.035，OR 2.919）。