Assessment Of Glucose And Lipid Metabolism In Patients With Adrenal Diseases Using Flash Glucose Monitoring System Combined With Dual-Energy X-ray Absorptiometry

Objective:Studies have shown that the metabolic changes of adrenal diseases including Cushing’s syndrome,pheochromocytoma,primary aldosteronism,and nonfunctional adrenal incidentaloma were described in the literature.In addition to abnormal blood pressure,there are hyperglycemia,dyslipidemia,excess fat accumulation and abnormal fat distribution,which increases the incidence and mortality of cardiovascular disease.Therefore,it is important to assess the glucolipid metabolism of patients with adrenal diseases.Methods:According to the criteria,seven healthy controls,six patients with Cushing’ s syndrome,eight patients with pheochromocytoma,ten patients with primary aldosteronism,and twelve patients with nonfunctional adrenal incidentaloma were collected in this study.Laboratory tests indexes and anthropometric parameters of all subjects were collected.At the same time,all were equipped with a sensor of flash glucose monitoring system,and blood glucose dynamic monitoring including general glucose variation indicators,within-day glucose variation indicators,day-to-day glucose variation indicators,and blood glucose-target-rate were analyzed.And their body composition of the whole body were measured by dual-energy X-ray absorptiometry.Through these parameters,glycolipid metabolism changes were investigated in patients with adrenal diseases.In addition,insulin resistance and islet β cells function of these subjects were evaluated.Results:The parameters of laboratory tests suggested that compared with the control group,patients in the Cushing’ syndrome group showed the significantly increased levels of Hb A1 c,total cholesterol,triglyceride and low density lipoprotein cholesterol;patients in the pheochromocytoma group showed the significantly increased levels of Hb A1 c,fasting blood glucose,total cholesterol,triglyceride and low density lipoprotein cholesterol,and significantly decreased high density lipoprotein cholesterol level;patients in the primary aldosteronism group showed no significant difference;and patients in the nonfunctional adrenal incidentaloma group showed the significantly increased levels of Hb A1 c,total cholesterol and triglyceride.The data of flash glucose monitoring system indicated there were statistical differences between adrenal diseases groups and control group in these indicators,including general glucose variation,within-day glucose variation,day-to-day glucose variation and blood glucose-target-rate.In the analysis of anthropometry and body composition,the body mass index,waist hip ratio and fat percentage in A area of Cushing’ syndrome patients were significantly higher than the control group;the waist hip ratio of pheochromocytoma and primary aldosteronism patients were significantly higher than the control group;the body mass index and waist hip ratio of nonfunctional adrenal incidentaloma patients were significantly higher than the control group.There were no significant difference in islet βcells function and insulin resistance accessed by homeostasis model in comparison of the control group and adrenal diseases groups.Conclusion:This study shows that patients with adrenal diseases presented with impaired glucose and lipid metabolism,which may increase the morbidity and mortality of cardiovascular disease.Therefore,for these patients,we should pay attention to the evaluation of glucose and lipid metabolism disorders.Flash glucose monitoring system can be used to assess glucose variation and detect early blood glucose abnormalities in patients with adrenal diseases,and dual-energy X-ray absorptiometry can be used to assess abnormal body fat distribution in these patients.For patients with adrenal diseases with abnormal glucose and lipid metabolism,while serum biochemistry tests are carried out,flash glucose monitoring system and dual-energy X-ray absorptiometry can be made use of assessing glucolipid metabolism,which helps to timely treatment and prevent the occurrence and development of cardiovascular disease.