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

Autor:	Spyroglou A; Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, UniversitätsSpital Zürich (USZ) and Universität Zürich (UZH), Zurich, Switzerland., Handgriff L; Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany., Müller L; Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany., Schwarzlmüller P; Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany., Parasiliti-Caprino M; Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy., Fuss CT; Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany., Remde H; Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany., Hirsch A; Endokrinologie in Charlottenburg, Berlin, Germany., O'Toole SM; Department of Endocrinology, St Bartholomew's Hospital, London, UK., Thuzar M; Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia., Petramala L; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Rome, Italy., Letizia C; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Rome, Italy., Deflorenne E; Hypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, Université de Paris, PARCC, Inserm, Paris, France., Amar L; Hypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, Université de Paris, PARCC, Inserm, Paris, France., Vrckovnik R; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Kocjan T; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Zhang CD; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Li D; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Singh S; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Katabami T; Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan., Yoneda T; Department of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan., Murakami M; Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Wada N; Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan., Inagaki N; Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan., Quinkler M; Endokrinologie in Charlottenburg, Berlin, Germany., Ghigo E; Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy., Maccario M; Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy., Stowasser M; Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia., Drake WM; Department of Endocrinology, St Bartholomew's Hospital, London, UK., Fassnacht M; Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany., Bancos I; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA., Reincke M; Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany., Naruse M; Endocrine Center and Clinical Research Center, Ijinkai Takeda General Hospital, Kyoto, Japan.; Clinical Research Institute of Endocrinology and Metabolism, NHO Kyoto Medical Center, Kyoto, Japan., Beuschlein F; Klinik 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.
Jazyk:	angličtina
Zdroj:	European journal of endocrinology [Eur J Endocrinol] 2022 Jul 21; Vol. 187 (3), pp. 361-372. Date of Electronic Publication: 2022 Jul 21 (Print Publication: 2022).
DOI:	10.1530/EJE-22-0040
Abstrakt:	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.
Databáze:	MEDLINE
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