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嗜铬细胞瘤和副神经节瘤患者中儿茶酚胺与血脂异常关系的深入探讨:一项大型中国队列研究。

An in-depth exploration of the catecholamine and dyslipidemia relationship in pheochromocytoma and paraganglioma patients: a large Chinese cohort study.

作者信息

Zhang Wenqian, Zhou Yue, Cui Yunying, Yu Jie, Li Tianyi, Feng Kai, Ren Weidong, Tong Anli, Li Yuxiu

机构信息

Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission of the People's Republic of China, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.

Department of Endocrinology, The First Affiliated Hospital of North University of Hebei, North University of Hebei, Zhangjiakou, 075000, China.

出版信息

Endocrine. 2025 May 14. doi: 10.1007/s12020-025-04277-w.

Abstract

OBJECTIVE

The aim is to investigate the relationship between catecholamine levels and dyslipidemia in pheochromocytoma and paraganglioma (PPGL) patients.

METHODS

Clinical data from 500 PPGL patients were retrospectively analyzed, including clinical demographics, genetic mutations, tumor size, preoperative catecholamine levels, and lipid profiles. Comparison of lipid levels before and after surgery were also conducted.

RESULTS

A total of 500 patients were included: 238 males (47.6%) and 262 females (52.4%), with an average age at diagnosis of 46.5 ± 15.4 years. The prevalence of dyslipidemia among PPGL patients was 59.2%. In different catecholamine secretion types, norepinephrine (NE) secreting type group had significantly higher total cholesterol levels (4.82 [4.21, 5.38] vs. 4.43 [3.78, 4.92] mmol/L, p < 0.0167) compared to the non-secreting type group. However, there were no significant differences in triglycerides, high-density lipoprotein, and low-density lipoprotein among different secretion types. This study showed the first detailed analysis of the distribution of elevated total cholesterol in different age groups and BMI categories. Patients with overweight had the highest rate of elevated total cholesterol (48.5%). Additionally, within different age brackets, individuals aged 51-60 years displayed the highest rate of abnormal total cholesterol levels. Comparison of preoperative and postoperative biochemical outcomes in 69 patients with PPGLs showed that surgical resection effectively reduced catecholamine levels and improved total cholesterol levels.

CONCLUSIONS

The incidence of dyslipidemia is high among patients with PPGL, and there exists strong link between lipid metabolism and catecholamine secretion, thus highlighting the importance of closely monitoring lipid levels in patients with PPGL.

摘要

目的

探讨嗜铬细胞瘤和副神经节瘤(PPGL)患者儿茶酚胺水平与血脂异常之间的关系。

方法

回顾性分析500例PPGL患者的临床资料,包括临床人口统计学、基因突变、肿瘤大小、术前儿茶酚胺水平和血脂谱。还对手术前后的血脂水平进行了比较。

结果

共纳入500例患者,其中男性238例(47.6%),女性262例(52.4%),诊断时的平均年龄为46.5±15.4岁。PPGL患者中血脂异常的患病率为59.2%。在不同的儿茶酚胺分泌类型中,去甲肾上腺素(NE)分泌型组的总胆固醇水平显著高于非分泌型组(4.82[4.21,5.38] vs. 4.43[3.78,4.92]mmol/L,p<0.0167)。然而,不同分泌类型之间的甘油三酯、高密度脂蛋白和低密度脂蛋白没有显著差异。本研究首次详细分析了不同年龄组和BMI类别中总胆固醇升高的分布情况。超重患者的总胆固醇升高率最高(48.5%)。此外,在不同年龄组中,51-60岁的个体总胆固醇水平异常率最高。对69例PPGL患者术前和术后生化指标的比较显示,手术切除有效降低了儿茶酚胺水平并改善了总胆固醇水平。

结论

PPGL患者血脂异常的发生率较高,脂质代谢与儿茶酚胺分泌之间存在密切联系,因此强调了密切监测PPGL患者血脂水平的重要性。

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