Clinical analysis of bilateral macronodular adrenal hyperplasia
10.3760/cma.j.issn.1000-6699.2018.12.005
- VernacularTitle:双侧肾上腺大结节样增生症的临床特征分析
- Author:
Kai WANG
1
;
Weiwei ZHOU
;
Yiran JIANG
;
Tingwei SU
;
Lei JIANG
;
Weiqing WANG
Author Information
1. 200025 上海交通大学医学院附属瑞金医院内分泌代谢病科,上海市内分泌代谢病研究所,上海市内分泌代谢病临床医学中心
- Keywords:
Bilateral macronodular adrenal hyperplasia;
Cortisol-producing adrenal adenoma;
Non-functional adenomas;
Adrenal Cushing's syndrome
- From:
Chinese Journal of Endocrinology and Metabolism
2018;34(12):1010-1014
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics in patients with bilateral macronodular adrenal hyperplasia ( BMAH). Methods We enrolled 357 patients with adrenal tumors including 42 BMAH, 167 cortisol-producing adrenal adenoma (CPA), and 148 non-functional adenomas (NFA). The clinical manifestations, hormonal explorations and complications were compared among groups. Results (1) Age at diagnosis of BMAH group was significantly higher than that of CPA group [(53.7±8.3 vs 41.1±13.1)years], female proportion of BMAH group was lower that that of CPA group(54.8%vs 88.0%, P＜0.01). Both were similar to NFA group. (2) Compared to NFA group, metabolic abnormalities were severer in BMAH and CPA groups. Prevalence of hypertension, diabetes mellitus, and hypokalemia were the highest in BMAH group. ( 3) BMAH patients had lower midnight serum cortisol, 24 hour urine free cortisol, and adrenocorticotrophic hormone levels than CPA patients (P＝0.008, 0.010, and P＝0.001, respectively). The suppression rate of serum cortisol after low-dose dexamethasone suppression test was significantly higher in BMAH group ( P＝ 0. 005). Conclusion BMAH patients were at higher age at diagnosis. Although hypercortisolism in BMAH patients is relatively slight, metabolic abnormalities are more severe. Besides functional diagnosis, physicians should pay more attention to the assessment of complications related to hypercortisolism.
