Abstract：
BACKGROUND: Patients with adrenal hormone excess demonstrate increased cardiovascular risk and mortality.
OBJECTIVE: We aimed to determine the impact of adrenal disorders on the inflammation marker GlycA, total branched-chain amino acids (BCAA), ketone bodies and the gut microbiome-derived metabolites trimethylamine N-oxide (TMAO) and betaine.
METHODS: We conducted a single-center cross-sectional study of patients with nonfunctioning adenomas (NFA), mild autonomous cortisol secretion (MACS), primary aldosteronism (PA), Cushing syndrome (CS), pheochromocytoma/paragangliomas (PPGL), other benign or malignant adrenal masses, and adrenocortical carcinoma (ACC) between January 2015 and July 2022 (n=802). Referent subjects included participants of the PREVEND (Prevention of Renal and Vascular End-stage Disease) study (n=5241). GlycA, BCAA, ketone bodies, TMAO, and betaine were measured using nuclear magnetic resonance spectroscopy. Multivariable logistic analyses were adjusted for age, sex, BMI, smoking, hypertension, diabetes mellitus and statin therapy.
RESULTS: In age-and sex-adjusted comparison to referent subjects, increased GlycA was noted in all patient categories, increased BCAA in NFA, MACS, CS, PA and ACC, increased TMAO in patients with other malignant adrenal masses, increased betaine in NFA and MACS, and increased ketone bodies in NFA, CS and ACC. Essentially similar findings were observed in fully adjusted analysis and after exclusion of subjects with diabetes and cardiovascular disease.
CONCLUSIONS: Patients with functioning and non-functioning adrenal masses demonstrated increased GlycA and BCAA, biomarkers associated with adverse cardiometabolic disorders and mortality. Patients with NFA demonstrated an adverse metabolic profile similar to patients with MACS and CS.
OBJECTIVE: We aimed to determine the impact of adrenal disorders on the inflammation marker GlycA, total branched-chain amino acids (BCAA), ketone bodies and the gut microbiome-derived metabolites trimethylamine N-oxide (TMAO) and betaine.
METHODS: We conducted a single-center cross-sectional study of patients with nonfunctioning adenomas (NFA), mild autonomous cortisol secretion (MACS), primary aldosteronism (PA), Cushing syndrome (CS), pheochromocytoma/paragangliomas (PPGL), other benign or malignant adrenal masses, and adrenocortical carcinoma (ACC) between January 2015 and July 2022 (n=802). Referent subjects included participants of the PREVEND (Prevention of Renal and Vascular End-stage Disease) study (n=5241). GlycA, BCAA, ketone bodies, TMAO, and betaine were measured using nuclear magnetic resonance spectroscopy. Multivariable logistic analyses were adjusted for age, sex, BMI, smoking, hypertension, diabetes mellitus and statin therapy.
RESULTS: In age-and sex-adjusted comparison to referent subjects, increased GlycA was noted in all patient categories, increased BCAA in NFA, MACS, CS, PA and ACC, increased TMAO in patients with other malignant adrenal masses, increased betaine in NFA and MACS, and increased ketone bodies in NFA, CS and ACC. Essentially similar findings were observed in fully adjusted analysis and after exclusion of subjects with diabetes and cardiovascular disease.
CONCLUSIONS: Patients with functioning and non-functioning adrenal masses demonstrated increased GlycA and BCAA, biomarkers associated with adverse cardiometabolic disorders and mortality. Patients with NFA demonstrated an adverse metabolic profile similar to patients with MACS and CS.
摘要：
背景：肾上腺激素过量患者心血管风险和死亡率增加。
目的：我们旨在确定肾上腺疾病对炎症标记GlycA的影响，总支链氨基酸（BCAA），酮体和肠道微生物组衍生的代谢产物三甲胺N-氧化物（TMAO）和甜菜碱。
方法：我们对无功能腺瘤（NFA）患者进行了单中心横断面研究，轻度自主皮质醇分泌（MACS），原发性醛固酮增多症（PA），库欣综合征（CS），嗜铬细胞瘤/副神经节瘤（PPGL），其他良性或恶性肾上腺肿块，2015年1月至2022年7月之间的肾上腺皮质癌（ACC）（n=802）。不同的受试者包括PREVEND（肾脏和血管终末期疾病的预防）研究的参与者（n=5241）。GlycA,BCAA,酮体,TMAO,和甜菜碱使用核磁共振波谱测量。多变量逻辑分析调整了年龄，性别,BMI,吸烟,高血压,糖尿病和他汀类药物治疗。
结果：在年龄和性别调整后与参考对象的比较中，在所有患者类别中均发现GlycA升高,在NFA中增加BCAA，MACS,CS,PA和ACC，其他恶性肾上腺肿块患者的TMAO升高，NFA和MACS中甜菜碱的增加，NFA中酮体增加，CS和ACC。在完全调整的分析中以及在排除患有糖尿病和心血管疾病的受试者之后观察到基本上相似的发现。
结论：有功能性和无功能性肾上腺肿块的患者表现出GlycA和BCAA增加，与不良心脏代谢紊乱和死亡率相关的生物标志物。NFA患者表现出与MACS和CS患者相似的不良代谢特征。
目的：我们旨在确定肾上腺疾病对炎症标记GlycA的影响，总支链氨基酸（BCAA），酮体和肠道微生物组衍生的代谢产物三甲胺N-氧化物（TMAO）和甜菜碱。
方法：我们对无功能腺瘤（NFA）患者进行了单中心横断面研究，轻度自主皮质醇分泌（MACS），原发性醛固酮增多症（PA），库欣综合征（CS），嗜铬细胞瘤/副神经节瘤（PPGL），其他良性或恶性肾上腺肿块，2015年1月至2022年7月之间的肾上腺皮质癌（ACC）（n=802）。不同的受试者包括PREVEND（肾脏和血管终末期疾病的预防）研究的参与者（n=5241）。GlycA,BCAA,酮体,TMAO,和甜菜碱使用核磁共振波谱测量。多变量逻辑分析调整了年龄，性别,BMI,吸烟,高血压,糖尿病和他汀类药物治疗。
结果：在年龄和性别调整后与参考对象的比较中，在所有患者类别中均发现GlycA升高,在NFA中增加BCAA，MACS,CS,PA和ACC，其他恶性肾上腺肿块患者的TMAO升高，NFA和MACS中甜菜碱的增加，NFA中酮体增加，CS和ACC。在完全调整的分析中以及在排除患有糖尿病和心血管疾病的受试者之后观察到基本上相似的发现。
结论：有功能性和无功能性肾上腺肿块的患者表现出GlycA和BCAA增加，与不良心脏代谢紊乱和死亡率相关的生物标志物。NFA患者表现出与MACS和CS患者相似的不良代谢特征。
