The metabolic phenotype of patients with primary aldosteronism: impact of subtype and sex – a multicenter-study of 3566 Caucasian and Asian subjects

in European Journal of Endocrinology
Authors:
Ariadni SpyroglouKlinik für Endokrinologie, Diabetologie und Klinische Ernährung, UniversitätsSpital Zürich (USZ) and Universität Zürich (UZH), Zurich, Switzerland

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Laura HandgriffMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany

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Lisa MüllerMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany

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Paul SchwarzlmüllerMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany

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Mirko Parasiliti-CaprinoEndocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy

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Carmina Teresa FussDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Hana RemdeDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Anna HirschEndokrinologie in Charlottenburg, Berlin, Germany

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Samuel Matthew O’TooleDepartment of Endocrinology, St Bartholomew’s Hospital, London, UK

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Moe ThuzarEndocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia

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Luigi PetramalaDepartment of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome ‘Sapienza’, Rome, Italy

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Claudio LetiziaDepartment of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome ‘Sapienza’, Rome, Italy

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Elisa DeflorenneHypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, Université de Paris, PARCC, Inserm, Paris, France

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Laurence AmarHypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, Université de Paris, PARCC, Inserm, Paris, France

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Rok VrckovnikDepartment of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Tomaz KocjanDepartment of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Catherine D ZhangDivision of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA

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Dingfeng LiDivision of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA

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Sumitabh SinghDivision of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA

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Takuyuki KatabamiDivision of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan

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Takashi YonedaDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan

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Masanori MurakamiDepartment of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

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Norio WadaDepartment of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan

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Nobuya InagakiDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan

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Marcus QuinklerEndokrinologie in Charlottenburg, Berlin, Germany

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Ezio GhigoEndocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy

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Mauro MaccarioEndocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy

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Michael StowasserEndocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia

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William M DrakeDepartment of Endocrinology, St Bartholomew’s Hospital, London, UK

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Martin FassnachtDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Irina BancosDivision of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA

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Martin ReinckeMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany

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Mitsuhide NaruseEndocrine Center and Clinical Research Center, Ijinkai Takeda General Hospital, Kyoto, Japan
Clinical Research Institute of Endocrinology and Metabolism, NHO Kyoto Medical Center, Kyoto, Japan

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Felix BeuschleinKlinik für Endokrinologie, Diabetologie und Klinische Ernährung, UniversitätsSpital Zürich (USZ) and Universität Zürich (UZH), Zurich, Switzerland
Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany

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Correspondence should be addressed to F Beuschlein; Email: felix.beuschlein@usz.ch
DOI:
https://doi.org/10.1530/EJE-22-0040
Volume/Issue:
Volume 187: Issue 3
Page Range:
361–372
Article Type:
Research Article
Online Publication Date:
21 Jul 2022
Copyright:
© European Society of Endocrinology 2022
Restricted access

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Background

Accumulating evidence suggests that primary aldosteronism (PA) is associated with several features of the metabolic syndrome, in particular with obesity, type 2 diabetes mellitus, and dyslipidemia. Whether these manifestations are primarily linked to aldosterone-producing adenoma (APA) or bilateral idiopathic hyperaldosteronism (IHA) remains unclear. The aim of the present study was to investigate differences in metabolic parameters between APA and IHA patients and to assess the impact of treatment on these clinical characteristics.

Methods

We conducted a retrospective multicenter study including 3566 patients with APA or IHA of Caucasian and Asian origin. We compared the prevalence of metabolic disorders between APA and IHA patients at the time of diagnosis and 1-year post-intervention, with special references to sex differences. Furthermore, correlations between metabolic parameters and plasma aldosterone, renin, or plasma cortisol levels after 1 mg dexamethasone (DST) were performed.

Results

As expected, APA patients were characterized by higher plasma aldosterone and lower serum potassium levels. Only female IHA patients demonstrated significantly worse metabolic parameters than age-matched female APA patients, which were associated with lower cortisol levels upon DST. One-year post-intervention, female adrenalectomized patients showed deterioration of their lipid profile, when compared to patients treated with mineralocorticoid receptor antagonists. Plasma aldosterone levels negatively correlated with the BMI only in APA patients.

Conclusions

Metabolic alterations appear more prominent in women with IHA. Although IHA patients have worse metabolic profiles, a correlation with cortisol autonomy is documented only in APAs, suggesting an uncoupling of cortisol action from metabolic traits in IHA patients.

Supplementary Materials

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Sept 2018 onwards Past Year Past 30 Days
Full Text Views 202 202 0
PDF Downloads 267 267 2

 

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Print ISSN:
0804-4643
Online ISSN:
1479-683X

     European Society of Endocrinology

Copyright:
© European Society of Endocrinology 2022
Page(s):
12
Article Type:
Research Article
Received Date:
18 Jan 2022
Accepted Date:
04 Jul 2022
Print Publication Date:
01 Sep 2022
Online Publication Date:
21 Jul 2022
Sept 2018 onwards Past Year Past 30 Days
Abstract Views 3811 3811 22
Full Text Views 202 202 0
PDF Downloads 267 267 2
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