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Journal of Medical Biochemistry
2020, vol. 39, br. 2, str. 240-248
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 23/01/2020
doi: 10.2478/jomb-2019-0035
Creative Commons License 4.0
Biohemijske i kliničke karakteristike pacijenata sa primarnim aldosteronizmom - iskustvo jednog centra
aKlinički centar Srbije, Klinika za endokrinologiju dijabetes i bolesti metabolizma, Beograd
bKlinički centar Srbije, Klinika za endokrinologiju dijabetes i bolesti metabolizma, Beograd + Univerzitet u Beogradu, Medicinski fakultet
cKlinički centar Srbije, Centar za anesteziologiju i reanimatologiju, Beograd + Univerzitet u Beogradu, Medicinski fakultet

e-adresa: natavujacic@gmail.com

Sažetak

Uvod: Primarni aldosteronizam (PA) je praćen povećanom prevalencom metaboličkih poremećaja, (oštećen glukozni i lipidni metabolizam i insulinska rezistencija), ali i češćim kardio vaskularnim, renalnim i komplikacijama centralnog nervnog sistema. Metode: Analizirane su retrospektivno biohemijske i kliničke karakteristike 40 pacijenata sa PA zbog aldosteron-produkujućeg adenoma (APA) i upoređene sa kontrolnim grupama od 40 pacijenata sa afunkcionim adrenalnim adenomom (NFA) i esencijalnom hipertenzijom (HT), i 20 pacijenata sa adrenalnim Cushing-ovim sindromom (CS) ili subkliničkim CS (SCS). Rezultati: Sistolni, dijastolni i srednji arterijski pritisci su bili značajno viši u grupi sa PA (p=0,004; p=0,002; p=0,001, redom) nego u grupi NFA+HT. PA pacijenti su imali dužu istoriju hipertenzije (p=0,001) nego pacijenti sa hiperkorticizmom i svi su imali hipokalemiju. Ova grupa je imala najmanji srednji prečnik tumora (p<0,001). Metabolički sindrom je bio značajno ređi u PA grupi (37,5% vs. 70% u CS+SCS i 65% u NFA+HT grupi; p=0,015), mada nije bilo značajne razlike u bilo kom analiziranom metaboličkom parametru među grupama. U PA grupi je nađen najveći procenat pacijenata sa glikoznom intolerancijom (81,8%), mada razlika nije bila značajna. Srednja vrednost BMI za sve tri grupe je bila u rangu prekomerne težine. Pacijenti sa PA su imali veći stepen mikroalbuminurije, veću tendencija ka javljanju kardiovaskularnih, renalnih i cerebrovaskularnih događaja, ali razlika nije bila značajna. Zaključak: Naši rezultati podržavaju značaj ranog prepoznavanja primarnog aldosteronizma na osnovu kliničke prezentacije, ali i povećanog korišćenja skrininga.

Ključne reči

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