METHODS: This retrospective cohort analysis compared erythrocytic parameters between patients with CS of pituitary (CD) and adrenal (aCS) etiology and age, sex, body mass index (BMI) and socioeconomic status-matched controls in a 1:5 ratio. Laboratory values at baseline were calculated as mean values during the year preceding CS diagnosis, and over one year thereafter.
RESULTS: The cohort included 397 CS patients (68.26% female; mean age 51.11 ± 16.85 years) and 1970 controls. Patients with CS had significantly higher baseline median levels of hemoglobin (Hgb) (13.70 g/dL vs. 13.12 g/dL [p < 0.0001]) and hematocrit (Hct) (41.64% vs. 39.80% [p < 0.0001]) compared to controls. These differences were observed for both CD and aCS and for both sexes. Patients who attained remission had Hgb and Hct levels comparable to controls (13.20 g/dL and 40.08% in patients with CD and aCS vs. 13.20 g/dL and 39.98% in controls). Meanwhile, those with persistent/recurrent disease maintained elevated levels. Patients with comorbid DM had similar Hgb but higher Hct (p = 0.0419), while patients without DM showed elevated erythrocytic values compared to controls (p < 0.0001).
CONCLUSIONS: Our data illustrates that erythrocytic parameters are directly influenced by glucocorticoid excess as Hgb and Hct are higher in patients with CS, and normalize after remission. We have identified the influence of DM on erythrocytic parameters in patients with CS for the first time.
方法:这项回顾性队列分析比较了垂体(CD)CS和肾上腺(aCS)病因和年龄之间的红细胞参数,性别,体重指数(BMI)和社会经济地位匹配的对照,比例为1:5。基线时的实验室值计算为CS诊断前一年的平均值,此后一年多。
结果:该队列包括397例CS患者(68.26%为女性;平均年龄51.11±16.85岁)和1970例对照。CS患者的血红蛋白(Hgb)基线中位数水平明显较高(13.70g/dLvs.13.12g/dL[p<0.0001])和血细胞比容(Hct)(41.64%vs.39.80%[p<0.0001])与对照组相比。对于CD和aCS以及两种性别都观察到了这些差异。获得缓解的患者的Hgb和Hct水平与对照组相当(CD和aCS患者的13.20g/dL和40.08%与13.20g/dL,对照组为39.98%)。同时,那些患有持续性/复发性疾病的患者保持较高的水平。合并症DM患者的Hgb相似,但Hct较高(p=0.0419),与对照组相比,无DM患者的红细胞值升高(p<0.0001)。
结论:我们的数据表明,由于CS患者的Hgb和Hct较高,因此红细胞参数受到糖皮质激素过量的直接影响。缓解后恢复正常.我们首次确定了DM对CS患者红细胞参数的影响。