Abstract
BackgroundThis study aimed to investigate the characteristics and extent of glycometabolism impairment in patients with adrenal diseases, including Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonfunctional adrenal incidentaloma.MethodsThis study enrolled thirty-two patients with adrenal diseases as adrenal disease groups and eight healthy individuals as healthy controls. Blood glucose levels were indicated by glucose concentration in interstitial fluid, which was documented using flash glucose monitoring system. According to flash glucose monitoring system data, parameters representing general blood glucose alterations, within-day and day-to-day glucose variability, and glucose-target-rate were calculated. Furthermore, blood glucose levels at nocturnal, fasting, and postprandial periods were analyzed. Besides, islet β-cell function and insulin resistance were assessed.ResultsAnalysis of flash glucose monitoring system-related parameters indicated impaired glycometabolism in patients with adrenal diseases compared with that of healthy controls at general blood glucose, within-day and day-to-day glucose variability, and glucose-target-rate levels. Furthermore, the dynamic glucose monitoring data revealed that significantly affected blood glucose levels compared with that of healthy controls were observed at postprandial periods in the Cushing syndrome and primary aldosteronism groups; at nocturnal, fasting and postprandial periods in the pheochromocytoma group. Significant insulin resistance and abnormal β-cell function were observed in the Cushing syndrome group compared with that in healthy controls.ConclusionAdrenal diseases can negatively affect glucose metabolism. Patients diagnosed with adrenal diseases should receive timely and appropriate treatment to avoid adverse cardiovascular events linked to hyperglycemia and insulin resistance.
Highlights
Adrenal glands are critical endocrine glands in the human body and responsible for various physiological functions such as metabolism of glucose, protein, lipid, water, and saline
The characteristics of the recruited subjects were showed in Supplementary File, including gender, age, body mass index, blood pressure, and plasma potassium for all the subjects; disease duration, tumor size, and pathological result for adrenal disease groups (ADs); and endocrinological data listed in the inclusion criteria for each ADs
Parameters representing within-day and day-today glucose variability (GV) showed that standard deviation of blood glucose (SDBG) was significantly higher, mean of daily differences (MODD) and area between 25–75 percentile curves (ABPC) was significantly different (P=0.006, and P=0.006, respectively) when compared with those of healthy controls (HCs), while mean amplitude of glycemic excursions (MAGE) didn’t find any significant difference from that in HCs
Summary
Adrenal glands are critical endocrine glands in the human body and responsible for various physiological functions such as metabolism of glucose, protein, lipid, water, and saline. Primary mechanisms underlying these functions are dependent on hormones secreted by the adrenals, mainly comprising glucocorticoids (GCs), aldosterone (ALD), and catecholamine (CA). Adrenal diseases, including Cushing syndrome (CS), primary aldosteronism (PA), and pheochromocytoma (Pheo) are linked to varying degrees of metabolic abnormalities by excessively secreted hormones. This study aimed to investigate the characteristics and extent of glycometabolism impairment in patients with adrenal diseases, including Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonfunctional adrenal incidentaloma
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