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

Autor: Ariadni Spyroglou, Laura Handgriff, Lisa Müller, Paul Schwarzlmüller, Mirko Parasiliti-Caprino, Carmina Teresa Fuss, Hana Remde, Anna Hirsch, Samuel Matthew O’Toole, Moe Thuzar, Luigi Petramala, Claudio Letizia, Elisa Deflorenne, Laurence Amar, Rok Vrckovnik, Tomaz Kocjan, Catherine D Zhang, Dingfeng Li, Sumitabh Singh, Takuyuki Katabami, Takashi Yoneda, Masanori Murakami, Norio Wada, Nobuya Inagaki, Marcus Quinkler, Ezio Ghigo, Mauro Maccario, Michael Stowasser, William M Drake, Martin Fassnacht, Irina Bancos, Martin Reincke, Mitsuhide Naruse, Felix Beuschlein
Rok vydání: 2022
Předmět:
Zdroj: European Journal of Endocrinology. 187:361-372
ISSN: 1479-683X
0804-4643
DOI: 10.1530/eje-22-0040
Popis: 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: OpenAIRE
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