Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
Sci Rep. 2023 Nov 28;13(1):20975. doi: 10.1038/s41598-023-48295-y.
The purpose of this study was to evaluate the effects of administration of overnight 1 mg dexamethasone on vascular function in patients with nonfunctioning adrenal adenomas (NFA). Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were measured to assess vascular function in 22 patients with NFA who had hypertension and/or diabetes mellitus (DM) and 272 patients without adrenal incidentalomas who had hypertension and/or DM (control patients with hypertension and/or DM). FMD and NID were measured in the morning before and after administration of 1 mg of dexamethasone at 2300 h in 18 patients with NFA. There were no significant differences in FMD and NID between control patients with hypertension and/or DM and patients with NFA who had hypertension and/or DM (3.4 ± 2.8% vs. 2.9 ± 1.9% and 11.5 ± 5.7% vs. 11.4 ± 4.3%, P = 0.46, and P = 0.99, respectively). There were no significant differences in vascular function between control patients with hypertension and/or DM and patients with NFA who had hypertension and/or DM even after adjustment for cardiovascular risk factors. Overnight 1 mg dexamethasone increased FMD from 2.4 ± 1.9% to 5.3 ± 3.2% (P < 0.01) and increased NID from 12.1 ± 4.2% to 14.0 ± 2.8% (P < 0.01) in patients with NFA. The overnight 1 mg dexamethasone suppression test does not impair FMD and NID in patients with NFA. Decreases in circulating levels of cortisol may improve vascular function.Clinical Trial Registration: This study was approved by principal authorities and ethical issues in Japan (URL for Clinical Trial: http://www.umin.ac.jp/ctr/index.htm Registration Number for Clinical Trial: UMIN000039512).
本研究旨在评估夜间给予 1 毫克地塞米松对无功能肾上腺腺瘤（NFA）患者血管功能的影响。我们测量了 22 例患有高血压和/或糖尿病（DM）的 NFA 患者及 272 例患有高血压和/或 DM 的无意外肾上腺瘤患者的血流介导的血管舒张功能（FMD）和硝酸甘油诱导的血管舒张功能（NID），以评估血管功能。我们在 18 例 NFA 患者于 23:00 接受 1 毫克地塞米松治疗前后的早晨测量了 FMD 和 NID。患有高血压和/或 DM 的 NFA 患者与患有高血压和/或 DM 的对照组患者之间的 FMD 和 NID 无显著差异（3.4±2.8%比 2.9±1.9%和 11.5±5.7%比 11.4±4.3%，P=0.46 和 P=0.99）。即使在校正心血管危险因素后，患有高血压和/或 DM 的 NFA 患者与对照组患者之间的血管功能也无显著差异。夜间 1 毫克地塞米松使 NFA 患者的 FMD 从 2.4±1.9%增加到 5.3±3.2%（P<0.01），使 NID 从 12.1±4.2%增加到 14.0±2.8%（P<0.01）。NFA 患者的 overnight 1 毫克地塞米松抑制试验不会损害 FMD 和 NID。循环皮质醇水平的降低可能会改善血管功能。临床试验注册：本研究已获得日本主要主管部门和伦理问题的批准（临床试验网址：http://www.umin.ac.jp/ctr/index.htm，临床试验注册号：UMIN000039512）。
