嗜铬细胞瘤患者肾上腺素和去甲肾上腺素和糖耐量异常的相关分析

doi:10.19558/j.cnki.10-1020/r.2021.01.008

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摘要 目的: 探讨儿茶酚胺释放类型对嗜铬细胞瘤患者糖耐量异常机制。方法: 评估诊断为嗜铬细胞瘤并接受手术切除的57例患者资料。根据血糖情况将患者分为糖耐量正常组和糖耐量异常组,并评估了手术前后的血压、血糖参数、胰岛素分泌参数（HOMA-β）、胰岛素抵抗参数（HOMA-IR）和手术前后24 h尿甲氧基肾上腺素、尿甲氧基去甲肾上腺素。结果: 糖耐量异常组术前平均收缩压高于糖耐量正常组。糖耐量异常组术后空腹血糖（FBG）,糖化血红蛋白（HbA1c）,HOMA-β和HOMA-IR明显改善。Spearman相关性分析显示,手术前后HOMA-β的改善与尿甲氧基肾上腺素改善呈正相关,手术前后HOMA-IR的改善与尿甲氧基去甲肾上腺素改善呈正相关。结论: 嗜铬细胞瘤的切除改善了糖耐量异常组血糖参数且不同类型儿茶酚胺引起糖耐量机制不同。肾上腺素增高主要影响胰岛素分泌减少,而去甲肾上腺增高主要影响胰岛素抵抗。

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	孙青风
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关键词 ：嗜铬细胞瘤, 儿茶酚胺, 糖耐量异常, 胰岛素分泌, 胰岛素抵抗

Abstract：Objective: To explore the mechanism of catecholamine release type on glucose intolerance in patients with pheochromocytoma. Methods: We evaluated 57 patients who were diagnosed as having pheochromocytoma and underwent surgical resection. Patients were divided into normal glucose tolerance group and abnormal glucose tolerance group. The blood glucose parameters, insulin secretion parameters （HOMA-β）, insulin resistance parameters （HOMA-IR） before and after operation, and 24-h urine metanephrine and urine normetanephrine were analyzed. Results: The mean preoperative systolic blood pressure in the impaired glucose tolerance group was higher than that in the normal glucose tolerance group. After operation, FBG, HbA1c, HOMA-β and HOMA-IR in impaired glucose tolerance group were significantly improved. Spearman correlation analysis showed that the improvement of HOMA-β before and after operation was positively correlated with the improvement of urinary metanephrine, and the improvement of HOMA-IR before and after operation was positively correlated with the improvement of urinary normetanephrine. Conclusion: The removal of pheochromocytoma improved blood glucose parameters in patients with impaired glucose tolerance, and the mechanisms of glucose tolerance induced by different catecholamines were different. The increase of adrenaline mainly affects the decrease of insulin secretion, while the increase of noradrenaline mainly affects insulin resistance.

Key words： pheochromocytoma catecholamine glucose intolerance insulin secretion insulin resistance

收稿日期: 2020-04-26

通讯作者: 郭宁宁,mler3208@163.com

引用本文:

孙青风, 郭宁宁, 关平, 田龙江, 翟玉章. 嗜铬细胞瘤患者肾上腺素和去甲肾上腺素和糖耐量异常的相关分析[J]. 微创泌尿外科杂志, 2021, 10(1): 31-34.
SUN Qingfeng, GUO Ningning, GUAN Ping, TIAN Longjiang, ZHAI Yuzhang. Effect of adrenaline and noradrenaline on glucose intolerance in patients with pheochromocytoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(1): 31-34.

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