siMS评分与原发性醛固酮增多症的相关性
| 作者: |
1郭静,
1凌宏威,
1周冬梅,
1孙娟,
1应长江,
1李伟
1 徐州医科大学附属医院内分泌科，江苏 徐州 221000 |
| 通讯: |
李伟
Email: liwei190@hotmail.com |
| DOI: | 10.3978/j.issn.2095-6959. 2018.12.011 |
| 基金: | 国家自然科学基金(81701298)。 |
摘要
目的：探讨原发性醛固酮增多症(primar y aldosteronism，PA)患者的血浆醛固酮(aldosteronism， ALD)水平与siMS评分[一种新的能连续性的评估代谢综合征(metabolic syndrome，MS)的评分方法]、siMS风险评分(在siMS评分的基础上，评估心脑血管并发症的风险)的相关性。方法：检测129名确诊为PA的患者，分为伴有MS组(64例)与不伴有MS组(65例)两组。测量指标包括身高、体重、腰围、血压、三酰甘油(TG)、高密度脂蛋白(high densit y lipoprotein，HDL)、载脂蛋白A(ApoA1)、载脂蛋白B(ApoB)、空腹血糖(fasting blood-glucose，FPG)、糖化血红蛋白(HbA1c)、纤维蛋白原(fibrinogen，FIB)、尿微量白蛋白(albuminuria，ALB)、C反应蛋白(C-reaction protein， CRP)、尿酸(ur ic ac id，SUA)、肌酐(SCr)、胱抑素C(CysC)等。采用国家胆固醇教育计划成人治疗小组I I I(NCEP ATP I I I)提出的MS的定义。siMS评分作为MS的连续测量指标。结果：PA合并MS组和不合并MS组间体重(P=0.003)，腰围(P=0.005)，FIB(P=0.008)，ApoB(P=0.010)， A poA1(P=0.007)，TG ( P<0.001)，HbA1c( P<0.001)，CR P ( P=0.016)，SUA ( P=0.045)， ALD(P=0.014)，FPG(P<0.001)，HDL(P<0.001)，ALB(P=0.026)的差异有统计学意义。两组间BMI(P=0.701)、平均动脉压(P=0.894)等指标的差异无统计学意义。siMS评分与ALD(P<0.001)， FIB(P=0.034)，CRP(P=0.002)，SUA(P=0.021)呈显著正相关。siMS风险评分与ALD(P<0.001)呈显著正相关。结论：siMS评分作为一种简便、经济的方法，可用来长期定量监测PA患者的治疗效果，及时纠正代谢紊乱，早期干预，降低远期心脑血管并发症的发生率。
关键词：
原发性醛固酮增多症；代谢综合征；siMS评分；动脉粥样硬化
Correlation between siMS score and primary aldosteronism
CorrespondingAuthor: LI Wei Email: liwei190@hotmail.com
DOI: 10.3978/j.issn.2095-6959. 2018.12.011
Foundation: This work was supported by the National Natural Science Foundation of China (81701298).
Abstract
Objective: To investigate the association of plasma aldosterone levels and siMS scores in patients with primary aldosteronism (PA) (a new, continuous assessment of metabolic syndrome) and siMS risk scores (in siMS scores) based on the assessment of the risk of cardiovascular and cerebrovascular complications). Methods: A total of 129 patients diagnosed with PA were enrolled and divided into two groups: a group with MS (64 patients) and group without metabolic syndrome (MS) (65 patients). Measurements include height, weight, waist circumference, blood pressure (BP), triglyceride (TG), high density lipoprotein (HDL), apolipoprotein A (ApoA1), apolipoprotein B (ApoB), fasting blood glucose (FPG), glycated hemoglobin (HbA1c), fibrinogen (FIB), urinary albumin (ALB), C-reactive protein (CRP), uric acid (SUA), creatinine (SCr), cystatin C (CysC), and so on. The definition of metabolic syndrome was proposed using the National Cholesterol Education Program Adult Therapy Group III (NCEP ATP III). The siMS score served as a continuous measure of metabolic syndrome. Results: The original aldehyde combined with MS group waist circumference, ApoB, triglyceride, glycosylated hemoglobin, fasting blood glucose, aldosterone, uric acid, and urine microalbumin were higher than those without MS, while ApoA1 and HDL in the combined MS group were lower than combine MS groups. There were no significant differences in BMI and mean arterial pressure between the two groups. The siMS score was significantly positively correlated with aldosterone (ALD), fibrinogen, C-reactive protein, and uric acid. The siMS risk score was significantly positively correlated with aldosterone. Conclusion: As a simple and economical method, siMS score can be used to monitor the therapeutic effect of patients with aldehydes for a long time, correct metabolic disorder in time, intervene early and reduce the incidence of long-term cardiovascular and cerebrovascular complications.
Keywords：
primary aldosteronism; metabolic syndrome; siMS score; atherosclerosis