Adrenal İnsidentalomalı Hastalarda Metabolik Parametreler
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Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: İnsidental olarak tespit edilen adrenal kitlesi olan hastalarda metabolik durumu belirlemek. Gereç ve Yöntemler: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bilim dalında Ocak 2010 ve Şubat 2014 tarihleri arasında yatırılarak fonksiyonel tarama yapılan adrenal insidentaloması olan 67 hasta çalışmaya dahil edildi. Bulgular: 67 hastanın 34ü erkek, 33ü kadındı. Hastaların yaş ortalaması 57.1 12, tüm hastaların vücut kütle indeksi 29.16 kg/m2 idi. Çalışmaya dahil edilen hastalara fonksiyonel tarama olarak; Cushing Sendromu, feok- romasitoma ve primer hiperaldesteronizme yönelik tarama testleri uygulandı. 67 hastanın 8 tanesi fonksiyone olarak (6 feokromasitoma, 1 Cushing Sendromu, 1 primerhiperaldesteronizm) tespit edildi. Hastaların 38 tane- sinde bozulmuş açlık glikozu veya tip 2 Diabetes Mellitus tespit edildi. Tüm hastaların ortalama glukoz değeri 127.618 mg/dl, fonksiyone olmayan hastaların ortalama glukozu 12962 mg/dl, fonksiyone olan hastaların glukoz ortalaması ise 117.232 mg/dl olarak ölçüldü. Tüm hastalarda sistolik kan basıncı 12518 mm/Hg, dias- tolik kan basıncı ise 7710.9 mm/Hg olarak ölçüldü. Fonksiyone hastaların ortalama sistolik basıncı 13510.4 mm/Hg iken, fonksiyone olmayan hastalarda 12419 mm/Hg tespit edildi. Tüm hastaların trigliserit, HDL, LDL kolesterol ölçümleri alındı. Sırasıyla ortalama değerleri; 157.583 mg/dl (normal 150mg/dl), 39.39.5 mg/dl (normal 40mg/dl), 120.137 mg/dl (normal 100mg/dl) bulundu. Sonuç: Çalışmamızda sürrenal insidentaloma hastalarının % 56sında insülin direncini gösteren bozulmuş açlık glukozu ve Tip 2 DM tespit edilmiştir. Klinik olarak fonksiyonel olmayan adrenal adenomların neden olduğu hafif kortizol fazlalığı tam olarak cushingoid görüntü gelişmesi için yeterli değilse de, insülin direnci ve bunun klinik sonuçlarına neden olabilmektedir. Bu artmış vücut kütle indeksi ve/veya insidentalomalı hastalarda subk- linik cushing sendromu sıklığı ile de ilişkili olabilir.
Aim: Our aim is to determine the metabolic state in patients with incidental adrenal mass. Material and Methods: 67 patients in whom functional tests about adrenal incidental mass were assessed in University of Necmettin Erbakan, Faculty of Medicine, Department of Endocrinology and Metabolism, were admitted to the study. Results: Of these 67 patients, 34 were male and 33 were female. Mean age was 57.1±12, mean body mass index was 29.1±6 kg/m2. In patients enrolled to the study; cushings syndrome, pheochromocytoma, primary hyperaldosteronism tests were performed. Functional adrenal mass was detected in 8 patients (6 pheochromocytoma, 1 cushings syndrome, 1 primary hyperaldosteronism). Impaired fasting glucose or type 2 diabetes were identified in 38 patients. Mean glucose was 127.6±18 mg/dL in all patients. Mean glucose in patients with functional and non-functional mass were 117.2±32 mg/dL and 129±62 mg/dL respectively. Mean systolic blood pressure was 125±18 mmHg, and diastolic blood pressure was 77±10.9 mmHg in all patients. Mean systolic pressure was 135±10.4 mmHg in patients with functional mass and 124±19 mmHg in patients with non-functional mass. Mean triglyceride was 157.5 ± 83 mg/dL (normal >150), HDL was 39.3 ± 9.5 mg/dL (normal >40) and LDL was 120.1 ± 37 mg/dL (normal >100) in all patients. Conclusion: In our study, impaired fasting glucose, indicating insulin resistance and Type 2 DM were detected in 56% of patients with adrenal incidentaloma. Although the mild cortisol excess by non-functional adrenal adenomas is not sufficient for the development of cushingoid appearance, it can lead to insulin resistance and its clinical consequences. Increased body mass index may be associated with subclinical Cushings syndrome in patients with incidentaloma.
Aim: Our aim is to determine the metabolic state in patients with incidental adrenal mass. Material and Methods: 67 patients in whom functional tests about adrenal incidental mass were assessed in University of Necmettin Erbakan, Faculty of Medicine, Department of Endocrinology and Metabolism, were admitted to the study. Results: Of these 67 patients, 34 were male and 33 were female. Mean age was 57.1±12, mean body mass index was 29.1±6 kg/m2. In patients enrolled to the study; cushings syndrome, pheochromocytoma, primary hyperaldosteronism tests were performed. Functional adrenal mass was detected in 8 patients (6 pheochromocytoma, 1 cushings syndrome, 1 primary hyperaldosteronism). Impaired fasting glucose or type 2 diabetes were identified in 38 patients. Mean glucose was 127.6±18 mg/dL in all patients. Mean glucose in patients with functional and non-functional mass were 117.2±32 mg/dL and 129±62 mg/dL respectively. Mean systolic blood pressure was 125±18 mmHg, and diastolic blood pressure was 77±10.9 mmHg in all patients. Mean systolic pressure was 135±10.4 mmHg in patients with functional mass and 124±19 mmHg in patients with non-functional mass. Mean triglyceride was 157.5 ± 83 mg/dL (normal >150), HDL was 39.3 ± 9.5 mg/dL (normal >40) and LDL was 120.1 ± 37 mg/dL (normal >100) in all patients. Conclusion: In our study, impaired fasting glucose, indicating insulin resistance and Type 2 DM were detected in 56% of patients with adrenal incidentaloma. Although the mild cortisol excess by non-functional adrenal adenomas is not sufficient for the development of cushingoid appearance, it can lead to insulin resistance and its clinical consequences. Increased body mass index may be associated with subclinical Cushings syndrome in patients with incidentaloma.
Açıklama
Anahtar Kelimeler
Adrenal insidentalom, Cushing sendromu, İnsülin direnci, Adrenal incidentaloma, Cushing’s syndrome, İnsulin resistance
Kaynak
Bozok Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
2
Künye
Kulaksızoğlu, M., Turan, E., Karakurt, F., Kaya, A. (2015). Adrenal insidentalomalı hastalarda metabolik parametreler. Bozok Tıp Dergisi, 5, 2, 1-3.
