肾上腺腺瘤型库欣综合征患者手术前后糖代谢情况变化

目的 评价肾上腺腺瘤型库欣综合征患者糖代谢情况及其手术后的变化.方法 检测29例腺瘤型库欣(组1)及14例亚临床库欣(组2)患者的血尿皮质醇、血促肾上腺皮质激素(ACTH)等指标,并行口服糖耐量(OGTT)试验,结果与24例正常对照者(组3)比较.组1、组2所有患者均经手术治疗,术后测值再与术前比较.结果 (1)根据W...

Changes in glucose metabolism in adrenal adenoma patients with Cushing's syndrome before and after operation

Objective To evaluate glucose metabolism disorder in adrenal adenoma patients with Cushing＇s syndrome, and observe changes before and after operation. Methods Twenty-nine adrenal adenoma patients with Cushing＇s syndrome （ group 1 ） and 14 patients with subclinical Cushing＇s syndrome （SCS） （ group 2） underwent laboratory tests of hematurian cortisol, adrenocorticotropic hormone （ACTH） and also had oral glucose tolerance test （OGTT）. The results obtained were compared with those of the 24 controls （group 3）. The patients of group 1 and 2 all had adrenalectomy. The data determined after operation was compared with those before operation. Results （ 1 ） As defined by the WHO criteria, the morbidity rates of diabetes in the 3 groups were 24.1% （7/29）, 21.4% （3/14） and 8.3 % （2/24）. In addition, other patients diagnosed to have impaired glucose regulation （IGR） accounted for 24.1% （7/ 29）, 28.6% （4/14） and 20.8% （5/24） respectively. Measurements indicated that insulin sensitivity index （ISI）, HOMA IR, AUCG and AUCI of the patients in group 1 were all higher than those of the patients in group 3, and the AUCG and AUCI of the patients in group 2 were higher than those of the patients in group 3. （2）Following decrease in the secretion of glucocorticoid hormone after operation, OGTT showed that levels of blood sugar, insulin, ISI, HOMA IR, AUCG and AUCI in the patients of group 1 and 2 all decreased to a more or less extent, when compared with those before operation. Accordingly, the prevalence of glucose disorder decreased in the patients of group 1 and 2. Conclusion The secretion of cortisol increased in patients with subclinical Cushing＇s syndrome and in adrenal adenoma patients with Cushing＇s syndrome, resulting in increased morbidity rate of glucose metabolism disorder. Symptoms could be improved following removal of the tumor.