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Objective To explore the differences of adrenal imaging indicators of patients with subclinical Cushing syndrome (SCS) and different cortisol levels, and analyze the related influencing factors. Methods Retrospectively analyze the clinical data of 65 patients with SCS admitted in the Department of Endocrinology of the First Medical Center of Chinese PLA General Hospital from January 2010 to January 2020. Subjects were undergone 1 mg dexamethasone suppression test (DST) at midnight, then with the blood cortisol level of 138 nmol/L at 8:00 am as a cut-off (1 mg DST-F8:00), divided into low-level group(n=36) and high-level group (n=29). The clinical characteristics, biochemical indicators, adrenocorticotropic hormone-cortisol(ACTH-F), tumor size, CT value and contralateral adrenal gland image of the two groups were compared. The relationship of contralateral adrenal width to the related factors between the both groups were analyzed by logistic regression, and then multivariate linear regression analysis was performed to analyze the relationship of the contralateral adrenal length, width and height to the different metabolic indicators. Results No statistically significant difference in the course of disease, body mass index (BMI),blood pressure, blood glucose, blood lipid, bone density, and related metabolic abnormalities existed between the two groups. While the patients were significantly younger (P<0.001), the SCS onset time was much earlier (P<0.001), and the proportion of female patients was higher (P=0.014) in high-level group than those in low-level group. In addition, the cortisol level at midnight (F00.00)and 1 mg DST-F8:00 were obviously higher in high-level group than those in low-level group (P<0.001). No significant difference existed between the two groups in tumor size, CT value, contralateral adrenal gland length, height and volume, but the width was thinner in high-level group than those in low-level group (P=0.07). The level of 1 mg DST-F8:00 in SCS patients was negatively correlated with the width of contralateral adrenal gland (β=–1.79, 95%CI –3.05-–0.52, P=0.007). Using sex, age, age of onset, course of disease, BMI, ACTH level, and tumor diameter as adjustment variables, logistic regression was singularly performed to analyze the relationship between 1 mg DST-F8:00 and the width of contralateral adrenal gland in SCS patients, then the results were still consistent. Multivariate linear regression showed that the width of contralateral adrenal gland was negatively correlated with diastolic blood pressure (β=–2.484, 95%CI –3.883-–1.085, P=0.002), while the contralateral adrenal length and height showed no obvious correlations with the metabolic index. Conclusion SCS patients with higher level of 1 mg DST-F8:00 had thinner contralateral adrenal gland width and with higher diastolic blood pressure.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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