PDF(Pubmed)
Abstract：
Aim of this study was to analyse the associations of cardiovascular health and adrenal gland volume as a rather new imaging biomarker of chronic hypothalamic-pituitary-adrenal (HPA) axis activation. The study population originates from the KORA population-based cross-sectional prospective cohort. 400 participants without known cardiovascular disease underwent a whole-body MRI. Manual segmentation of adrenal glands was performed on VIBE-Dixon gradient-echo sequence. MRI based evaluation of cardiac parameters was achieved semi-automatically. Cardiometabolic risk factors were obtained through standardized interviews and medical examination. Univariate and multivariate associations were derived. Bi-directional causal mediation analysis was performed. 351 participants were eligible for analysis (56 ± 9.1 years, male 58.7%). In multivariate analysis, significant associations were observed between adrenal gland volume and hypertension (outcome hypertension: Odds Ratio = 1.11, 95% CI [1.01, 1.21], p = 0.028), left ventricular remodelling index (LVRI) (outcome LVRI: β = 0.01, 95% CI [0.00, 0.02], p = 0.011), and left ventricular (LV) wall thickness (outcome LV wall thickness: β = 0.06, 95% CI [0.02, 0.09], p = 0.005). In bi-directional causal mediation analysis adrenal gland volume had a borderline significant mediating effect on the association between hypertension and LVRI (p = 0.052) as well as wall thickness (p = 0.054). MRI-based assessment of adrenal gland enlargement is associated with hypertension and LV remodelling. Adrenal gland volume may serve as an indirect cardiovascular imaging biomarker.
摘要：
这项研究的目的是分析心血管健康和肾上腺体积的关系，作为慢性下丘脑-垂体-肾上腺（HPA）轴激活的一种相当新的成像生物标志物。研究人群来自基于KORA人群的横断面前瞻性队列。400名没有已知心血管疾病的参与者接受了全身MRI检查。在VIBE-Dixon梯度回波序列上进行肾上腺的手动分割。基于MRI的心脏参数评估是半自动实现的。通过标准化访谈和医学检查获得心脏代谢危险因素。得出单变量和多变量关联。进行了双向因果中介分析。351名参与者符合分析条件(56±9.1年，男性58.7%)。在多变量分析中，在肾上腺体积和高血压之间观察到显著关联(高血压结局:赔率比=1.11,95%CI[1.01,1.21],p=0.028),左心室重塑指数（LVRI）（结果LVRI：β=0.01，95%CI[0.00，0.02]，p=0.011),和左心室（LV）壁厚度（结果LV壁厚度：β=0.06，95％CI[0.02，0.09]，p=0.005)。在双向因果调解分析中，肾上腺体积对高血压与LVRI（p=0.052）以及壁厚（p=0.054）之间的关联具有重要的中介作用。基于MRI的肾上腺肿大评估与高血压和LV重塑相关。肾上腺体积可作为间接心血管成像生物标志物。
