Autonomous cortisol secretion in patients with primary aldosteronism: prevalence and implications on cardiometabolic profile and on surgical outcomes.

Autor:	Araujo-Castro M; Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain.; University of Alcalá, Madrid, Spain., Paja Fano M; Department of Endocrinology & Nutrition, OSI Bilbao-Basurto, Hospital Universitario de Basurton & Basque Country University, Medicine Department, Bilbao, Spain., Pla Peris B; Department of Endocrinology & Nutrition, Hospital Universitario de Castellón, Castellón, Spain., González Boillos M; Department of Endocrinology & Nutrition, Hospital Universitario de Castellón, Castellón, Spain., Pascual-Corrales E; Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain., García-Cano AM; Department of Biochemistry, Hospital Universitario Ramón y Cajal, Madrid, Spain., Parra Ramírez P; Department of Endocrinology & Nutrition, Hospital Universitario La Paz Madrid, Spain., Rojas-Marcos PM; Department of Endocrinology & Nutrition, Hospital Universitario La Paz Madrid, Spain., Ruiz-Sanchez JG; Department of Endocrinology & Nutrition, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., Vicente A; Department of Endocrinology & Nutrition, Hospital Universitario de Toledo, Toledo, Spain., Gómez-Hoyos E; Department of Endocrinology & Nutrition, Hospital Universitario de Valladolid, Valladolid, Spain., Ferreira R; Department of Endocrinology & Nutrition, Hospital Universitario Rey Juan Carlos, Madrid, Spain., García Sanz I; Department of General & Digestive Surgery, Hospital Universitario de La Princesa, Madrid, Spain., Recasens M; Department of Endocrinology & Nutrition, Institut Català de la Salut Girona, Girona, Spain., Barahona San Millan R; Department of Endocrinology & Nutrition, Institut Català de la Salut Girona, Girona, Spain., Picón César MJ; Department of Endocrinology & Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, IBIMA Malaga, Spain CIBEROBN, Madrid, Spain., Díaz Guardiola P; Department of Endocrinology & Nutrition, Hospital Universitario Infanta Sofía, Madrid, Spain., Perdomo C; Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain., Manjón L; Department of Endocrinology & Nutrition, Hospital Universitario Central de Asturias & Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain., García-Centeno R; Department of Endocrinology & Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain., Percovich JC; Department of Endocrinology & Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain., Rebollo Román Á; Department of Endocrinology & Nutrition, Hospital Reina Sofía, Córdoba, Spain., Gracia Gimeno P; Department of Endocrinology & Nutrition, Hospital Rollo Villanova, Zaragoza, Spain., Robles Lázaro C; Department of Endocrinology & Nutrition, Complejo Universitario de Salamanca, Salamanca, Spain., Morales M; Biochemistry and Molecular Genetics Department-CDB, Hospital Clinic, IDIBAPS, CIBERehd, Barcelona, Spain., Calatayud M; Department of Endocrinology & Nutrition, Hospital Doce de Octubre, Madrid, Spain., Collao SAF; Department of Endocrinology & Nutrition, Hospital Doce de Octubre, Madrid, Spain., Meneses D; Department of Endocrinology & Nutrition, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain., Sampedro Nuñez MA; Department of Endocrinology & Nutrition, Hospital Universitario La Princesa, Madrid, Spain., Escudero Quesada V; Department of Nephrology, Hospital Universitario Doctor Peser, Valencia, Spain., Ribas EM; Department of Endocrinology & Nutrition, Hospital Universitario Son Espases, Islas Baleares, Spain., Sanmartín Sánchez A; Department of Endocrinology & Nutrition, Hospital Universitario Son Espases, Islas Baleares, Spain., Diaz CG; Department of Endocrinology & Nutrition, Hospital Universitario De Albacete, Albacete, Spain., Lamas C; Department of Endocrinology & Nutrition, Hospital Universitario De Albacete, Albacete, Spain., Guerrero-Vázquez R; Department of Endocrinology & Nutrition, Hospital Virgen de la Macarena, Sevilla, Spain., Del Castillo Tous M; Department of Endocrinology & Nutrition, Hospital Virgen de la Macarena, Sevilla, Spain., Serrano J; Department of Endocrinology & Nutrition, Hospital General Universitario de Alicante, Alicante, Spain., Michalopoulou T; Department of Endocrinology and Nutrition, Joan XXIII University Hospital, Tarragona, Spain., Moya Mateo EM; Internal Medicine, Hospital Infanta Leonor de Vallecas, Madrid, Spain., Hanzu F; Department of Endocrinology & Nutrition, Hospital Clinic, IDIPAS, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Endocrine connections [Endocr Connect] 2023 Aug 02; Vol. 12 (9). Date of Electronic Publication: 2023 Aug 02.
DOI:	10.1530/EC-23-0043
Abstrakt:	Purpose: The aim of this study was to evaluate the prevalence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) and its implications on cardiometabolic and surgical outcomes. Methods: This is a retrospective multicenter study of PA patients who underwent 1 mg dexamethasone-suppression test (DST) during diagnostic workup in 21 Spanish tertiary hospitals. ACS was defined as a cortisol post-DST >1.8 µg/dL (confirmed ACS if >5 µg/dL and possible ACS if 1.8-5 µg/dL) in the absence of specific clinical features of hypercortisolism. The cardiometabolic profile was compared with a control group with ACS without PA (ACS group) matched for age and DST levels. Results: The prevalence of ACS in the global cohort of patients with PA (n = 176) was 29% (ACS-PA; n = 51). Ten patients had confirmed ACS and 41 possible ACS. The cardiometabolic profile of ACS-PA and PA-only patients was similar, except for older age and larger tumor size of the adrenal lesion in the ACS-PA group. When comparing the ACS-PA group (n = 51) and the ACS group (n = 78), the prevalence of hypertension (OR 7.7 (2.64-22.32)) and cardiovascular events (OR 5.0 (2.29-11.07)) was higher in ACS-PA patients than in ACS patients. The coexistence of ACS in patients with PA did not affect the surgical outcomes, the proportion of biochemical cure and clinical cure being similar between ACS-PA and PA-only groups. Conclusion: Co-secretion of cortisol and aldosterone affects almost one-third of patients with PA. Its occurrence is more frequent in patients with larger tumors and advanced age. However, the cardiometabolic and surgical outcomes of patients with ACS-PA and PA-only are similar.
Databáze:	MEDLINE
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