Prevalence of primary aldosteronism among patients with type 2 diabetes
| Autor: | Mauro Tancredi, Björn Eliasson, Marcus Lind, Robert Eggertsen, Ulf Lindblad, Sofia Dahlqvist, Gudmundur Johannsson, Henrik Imberg |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Blood Pressure Hypokalemia 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology Nephropathy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Endocrinology Primary aldosteronism Diabetes mellitus Internal medicine Hyperaldosteronism Prevalence medicine Humans Outpatient clinic Aldosterone Aged Aged 80 and over Sweden business.industry Middle Aged medicine.disease Cross-Sectional Studies Blood pressure Diabetes Mellitus Type 2 chemistry Female business |
| Zdroj: | Clinical Endocrinology. 87:233-241 |
| ISSN: | 0300-0664 |
| DOI: | 10.1111/cen.13370 |
| Popis: | Context: Diabetes and hypertension coexist in 40%-60% of individuals with type 2 diabetes. The coexistence of these two conditions is associated with increased risk of retinopathy, nephropathy and cardiovascular disease. Objective: To investigate the prevalence of primary aldosteronism (PA) in a general cohort of persons with type 2 diabetes. Design: Cross-sectional study involving six diabetes outpatient clinics in Sweden. Patients: were enrolled individuals with type 2 diabetes between February 2008 and December 2013. Measurements: Plasma aldosterone concentrations (PAC pmol/L) and direct renin concentrations (DRC mIU/L) were measured. Patients with increased aldosterone renin ratios (ARR) > 65 were further evaluated for PA. Results: Of 578 consecutively screened patients with type 2 diabetes, 27 were treated with mineralocorticoid receptor antagonists (MRA) and potassium-sparing diuretics not further evaluated. Among the remaining 551 patients, 38 had increased ARR, including 22 who were clinically indicated for PA tests and 16 who were not further evaluated due to severe comorbidities and old age. There were five (0.93%) patients with confirmed PA after computerized tomography and adrenal venous sampling. Patients with PA had higher systolic blood pressure (P=.032) and lower potassium levels (P=.027) than those without PA. No significant association was found between plasma aldosterone and diabetic complications. Conclusions: The prevalence of PA in an unselected cohort of patients with type 2 diabetes is relatively low, and measures of plasma aldosterone are not strong risk factors for micro-and macrovascular diabetic complications. |
| Databáze: | OpenAIRE |
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