曾发生过心脑血管事件的原发性醛固酮增多症患者对促肾上腺皮质激素刺激的醛固酮反应性很高。

IF 1.3 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Endocrine journal Pub Date : 2024-05-23 Epub Date: 2024-03-14 DOI:10.1507/endocrj.EJ23-0659
Eriko Nakano, Kosuke Mukai, Atsunori Fukuhara, Michio Otsuki, Iichiro Shimomura, Takamasa Ichijo, Mika Tsuiki, Norio Wada, Takashi Yoneda, Yoshiyu Takeda, Kenji Oki, Tetsuya Yamada, Yoshihiro Ogawa, Daisuke Yabe, Miki Kakutani, Masakatsu Sone, Takuyuki Katabami, Akiyo Tanabe, Mitsuhide Naruse
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引用次数: 0

摘要

原发性醛固酮增多症(PA)患者的醛固酮分泌除自主分泌外,通常还受促肾上腺皮质激素(ACTH)的调节。然而,醛固酮对 ACTH 刺激有反应的 PA 患者的临床特征和发生心脑血管(CCV)事件的风险仍不清楚。本研究旨在调查醛固酮对 ACTH 刺激反应性高的 PA 患者中 CCV 事件的发生率。作为日本原发性醛固酮增多症研究/日本罕见难治性肾上腺疾病项目的一部分,本研究进行了一项回顾性横断面研究。2006年1月至2019年3月期间接受肾上腺静脉采样(AVS)的PA患者被纳入研究。AVS期间下腔静脉的ACTH刺激血浆醛固酮浓度(PAC)用于评估醛固酮对ACTH的反应性。我们分析了反应性与既往 CCV 事件之间的关系。逻辑回归分析表明,在调整了经典的 CCV 事件风险因素、基线 PAC 和高血压持续时间后,ΔPAC(ACTH 刺激前后的 PAC 测量值之差)会显著增加 PA 患者之前发生 CCV 事件的几率(相对 PAC:比值比 [OR],2.896;95% 置信区间 [CI],0.989-8.482;ΔPAC:比值比 [OR],2.344;95% 置信区间 [CI],0.989-8.482):OR,2.344;95% CI,1.149-4.780;ACTH 刺激的 PAC:OR,2.098;95% CI,0.694-6.339)。这项研究清楚地表明,醛固酮对 ACTH 的反应性与之前的 CCV 事件密切相关。PAC对ACTH的反应性有助于预测CCV事件风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary aldosteronism patients with previous cardiovascular and cerebrovascular events have high aldosterone responsiveness to ACTH stimulation.

Aldosterone secretion in primary aldosteronism (PA) is often regulated by adrenocorticotropic hormone (ACTH) in addition to its autonomous secretion. However, the clinical characteristics and risk of cardiovascular and cerebrovascular (CCV) events in PA patients with aldosterone responsiveness to ACTH stimulation remain unclear. This study aimed to investigate the prevalence of CCV events in PA patients with high aldosterone responsiveness to ACTH stimulation. A retrospective cross-sectional study was conducted as part of the Japan Primary Aldosteronism Study/Japan Rare Intractable Adrenal Disease project. PA patients with adrenal venous sampling (AVS) between January 2006 and March 2019 were enrolled. The ACTH-stimulated plasma aldosterone concentration (PAC) of the inferior vena cava during AVS was used to evaluate aldosterone responsiveness to ACTH. We analyzed the relationship between responsiveness and previous CCV events. Logistic regression analysis demonstrated that the ΔPAC (the difference between the PAC measurements before and after ACTH stimulation) significantly increased the odds of previous CCV events in PA patients after adjusting for classical CCV event risk factors, baseline PAC and duration of hypertension (relative PAC: odds ratio [OR], 2.896; 95% confidence interval [CI], 0.989-8.482; ΔPAC: OR, 2.344; 95% CI, 1.149-4.780; ACTH-stimulated PAC: OR, 2.098; 95% CI, 0.694-6.339). This study clearly demonstrated that aldosterone responsiveness to ACTH is closely related to previous CCV events. The responsiveness of the PAC to ACTH could be useful in predicting CCV event risk.Registration Number in UMIN-CTR is UMIN000032525.

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来源期刊
Endocrine journal
Endocrine journal 医学-内分泌学与代谢
CiteScore
4.30
自引率
5.00%
发文量
224
审稿时长
1.5 months
期刊介绍: Endocrine Journal is an open access, peer-reviewed online journal with a long history. This journal publishes peer-reviewed research articles in multifaceted fields of basic, translational and clinical endocrinology. Endocrine Journal provides a chance to exchange your ideas, concepts and scientific observations in any area of recent endocrinology. Manuscripts may be submitted as Original Articles, Notes, Rapid Communications or Review Articles. We have a rapid reviewing and editorial decision system and pay a special attention to our quick, truly scientific and frequently-citable publication. Please go through the link for author guideline.
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