目的:以往关于原发性醛固酮增多症(PA)和甲状腺疾病的研究存在争议。因此,这项研究旨在检查甲状腺功能,甲状腺疾病,和PA及其亚型。
方法:这是一项横断面研究,纳入2011年8月至2022年6月新疆维吾尔自治区人民医院高血压中心收治的PA患者1023例,原发性高血压患者6138例。通过肾上腺静脉采样(AVS)将所有PA患者准确分为醛固酮产生腺瘤(APA)和特发性醛固酮增多症(IHA)。采用多因素logistic回归分析评估甲状腺功能、甲状腺结节,和PA及其亚型。
结果:共有7161例患者(327APA和696IHA,包括6138EH),平均年龄为48.20±8.83岁。PA患者和PA亚型显示较低的FT4,FT3,TT4,TT3和TPOAb阳性的患病率,同时甲状腺结节的患病率高于EH患者(PA:56.10%,IHA:56.90%,APA:54.80%,和EH:48.90%,分别)。PA(校正OR:1.290,95%CI:1.035-1.607,P=.02)及其亚型(IHA)(校正OR:1.316,95%CI:1.005-1.724,P=.04)与甲状腺结节显着相关。与血浆醛固酮浓度(PAC)水平较低(<12ng/dL)的患者相比,PAC水平≥12ng/dL的患者甲状腺结节患病率较高.
结论:与EH患者相比,PA患者的甲状腺功能较低,甲状腺结节的患病率较高。因此,甲状腺功能和甲状腺结节的筛查可能是PA患者不可或缺的.
OBJECTIVE: Previous studies focusing on primary aldosteronism (PA) and thyroid diseases were controversial. Hence, this study aimed to examine associations between thyroid function, thyroid diseases, and PA and its subtypes.
METHODS: This was a cross-sectional study, which enrolled 1023 patients with PA and 6138 patients with essential hypertension (EH) admitted to Hypertension Center of People\'s Hospital of Xinjiang Uygur Autonomous Region from August 2011 to June 2022. All patients with PA were accurately classified into
aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) by adrenal vein sampling (AVS). Multivariate logistic regression analysis was used to assess the relationship of thyroid function, thyroid nodules, and PA and its subtypes.
RESULTS: A total of 7161 patients (327 APA and 696 IHA, and 6138 EH) were included with a mean age of 48.20 ± 8.83 years. PA patients and PA subtypes showed lower FT4, FT3, TT4, TT3, and prevalence of positive TPOAb, meanwhile higher prevalence of thyroid nodules than EH patients (PA: 56.10%, IHA: 56.90%, APA: 54.80%, and EH: 48.90%, respectively). PA (adjusted OR: 1.290, 95% CI: 1.035-1.607, P = .02) and its subtype (IHA) (adjusted OR: 1.316, 95% CI: 1.005-1.724, P = .04) were significantly associated with thyroid nodules. Compared to patients with lower plasma
aldosterone concentration (PAC) levels (<12 ng/dL), patients with PAC levels ≥ 12 ng/dL presented a higher prevalence of thyroid nodules.
CONCLUSIONS: PA patients had lower thyroid function and higher prevalence of thyroid nodules compared to EH patients. Therefore, the screening of thyroid function and thyroid nodules may be indispensable for PA patients.