Endocrine Abstracts

JOINT2021

Introduction: Pheochromocytomas (PCC) are neuroendocrine tumors that develop in the chromaffin cells of the adrenal medulla. They are responsible for hyperproduction of catecholamines. Among the abnormalities that can be observed in these tumors are disorders of carbohydrate metabolism (1).

MaterialS and Methods: Through a retrospective descriptive study of 48 patients diagnosed with PCC in our departement of Endocrinology, we describe the observed abnormalities of carbohydrate metabolism in this population.

Results: The average age of our patients was 40,9 years. The sex ratio was 0.45 with 15 men and 33 women. The average of BMI was 23,11 kg/m², 50% of our patients had high blood pression. Urinary methoxylate drifts were performed in 44 patients, 42 of whom had elevated levels. Abdominal CT was performed in 44 patients, while the remaining 4 patients benefited from abdominal MRI in the context of concomitant pregnancy. Thirty-three percent of our patients had moderate fasting hyperglycemia, while diabetes was diagnosed in 29,16 % of cases who were put on non-insulin hypoglycemic agents and/or insulin, attached to the PCC and 6.25% of patients had type 2 diabetes already treated with insulin.

Discussion and Conclusion: Catecholamines exert their physiological effects via adrenergic receptors (α and β) for adrenaline and noradrenaline, and dopaminergic receptors (DA1, DA2) for dopamine. Catecholamine-induced hyperglycemia is mediated by alpha1 receptors. The consequences of their activation are increased lipolysis with the release of fatty acids constituting precursors of gluconeogenesis, glycogenolysis releasing glucose and inhibition of insulin secretion. On the other hand, activation of beta2 receptors has a hypoglycemic effect by stimulating insulin secretion, a little-known, rare but serious effect. In general, the alpha-adrenergic action predominates, hence the frequency of hyperglycemia during PCC (26%) (2). Carbohydrate abnormalities during PCC can be greatly improved after tumor resection (3), which is why it is important to detect them in order to manage them early and correctly.

Key words: Phéochromocytome, Catecholamines, Hyperglycemia, Diabetes.