Insulin sensitivity and pancreatic β-cell function in patients with primary aldosteronism

Grewal, Shivraj; Fosam, Andin; Chalk, Liam; Deven, Arjun; Suzuki, Mari; Correa, Ricardo; Blau, Jenny; Demidowich, Andrew P.; Stratakis, Constantine A.; Muniyappa, Ranganath

doi:10.1007/s12020-020-02576-y

Cited by 9 publications

(8 citation statements)

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“…Most of the studies (22 of 27) evidenced high quality with a low risk of bias ( 2 , 13 , 14 , 26 – 28 , 30 – 33 , 35 , 36 , 38 – 44 , 46 – 48 ). The other five studies ( 25 , 29 , 34 , 37 , 45 ) showed moderate quality with a moderate risk of bias due to 1) important confounders not being identified and appropriately controlled for by proper statistical analyses for cross-sectional studies and 2) not being evaluated regarding the outcomes issues as measured outcomes were not relevant to the primary objectives of the current study for cohort studies. Details of the risk of bias scores for each study are shown in the Supplementary Appendix .…”

Section: Resultsmentioning

confidence: 98%

“…The full texts of the remaining 50 articles were retrieved and reviewed resulting in the exclusion of an additional 23 articles due to multiple reasons including conference abstracts, comparator groups not EH, already matched for diabetes, did not provide outcomes of interest, written in a language other than English, full text not accessible, and review articles using the same cohort as an included study. Finally, a total of 27 studies were included ( 2 , 13 , 14 , 25 – 48 ). The study selection process is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Regarding outcomes, 15 studies provided data on the prevalence of DM ( 2 , 13 , 14 , 27 – 29 , 31 , 32 , 34 , 35 , 37 – 39 , 47 , 48 ), 4 studies on IFG ( 2 , 14 , 35 , 40 ) and 5 studies on IGT ( 25 , 28 , 35 , 36 , 47 ). Twenty studies included data on FBG ( 2 , 14 , 25 , 27 , 28 , 30 , 32 , 34 – 38 , 40 – 47 ) with 10 studies excluded DM patients or discontinuing hypoglycemic agents before recruitment ( 25 , 30 , 36 , 40 – 46 ), 7 on HbA1c ( 13 , 25 , 26 , 30 , 31 , 36 ), 5 on 2-hr OGTT ( 25 , 30 , 32 , 36 , 47 ), 10 on HOMA-IR ( 25 , 26 , 28 , 30 , 33 , 36 , 41 – 44 ), 5 on HOMA-ß ( 26 , 30 , 33 , 43 , 45 ), 3 on AUC of glucose ( 25 , 26 , 45 ), 4 on AUC of insulin ( 25 , 26 ...…”

Section: Resultsmentioning

confidence: 99%

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Differences in Glycemic Abnormalities Between Primary Aldosteronism and Essential Hypertension: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundThe relationship of glycemic abnormalities between primary aldosteronism (PA) patients and essential hypertension (EH) patients is still debatable. This meta-analysis aimed to explore differences in the prevalence of glycemic abnormalities and levels of abnormal glucose metabolism in PA and EH patients.MethodsA search was performed using PubMed, Scopus, Cochrane and Web of Science databases from their inception through January 2022. Inclusion criteria for this study were 1) observational studies which contained specific data of interest, 2) studies including data which compared adult PA and EH patients and 3) studies which used appropriate methods to diagnose PA. Risk ratio (RR) or standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated.ResultsTwenty-six studies involving 53,186 patients were included in the meta-analysis. Patients with PA demonstrated significantly higher overall incidence of glycemic abnormalities than patients with EH [RR 1.54; 95% CI (1.20,1.98)]. Risk of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in PA patients were higher than in EH patients [RR 1.27; 95%CI (1.08, 1.49) and RR 2.99; 95%CI (1.74, 5.16), respectively]. There was no statistically significant difference of risk between these groups for impaired fasting glucose (IFG) [RR 1.70; 95%CI (0.55, 5.26)]. Moderate heterogeneity was observed in overall glycemic abnormalities outcomes. A high level of heterogeneity was observed for IFG, while the level was low for DM and IGT.ConclusionsPA patients have a higher risk of glycemic abnormalities than in EH patients. Further study should be conducted to investigate underlying mechanisms of glycemic abnormalities in PA.Systematic Review Registrationwww.inplasy.com, INPLASY, identifier 202220004.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Differences in Glycemic Abnormalities Between Primary Aldosteronism and Essential Hypertension: A Systematic Review and Meta-Analysis

et al. 2022

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“…Overproduction of aldosterone, also known as primary aldosteronism (PA), is the most common secondary cause of hypertension, and the prevalence of PA in patients with hypertension is 5–15% [ 1 , 2 ]. It is also associated with cardiovascular and renal complications, as well as metabolic alterations, such as insulin intolerance and obesity [ 3 , 4 , 5 ]. Moreover, mortality due to cardiovascular complications is higher in patients with PA than in those with essential hypertension (EH) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Aldosterone on Cardiorenal and Metabolic Systems

Otsuka

Abe

Kobayashi

2023

IJMS

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Aldosterone, a vital hormone of the human body, has various pathophysiological roles. The excess of aldosterone, also known as primary aldosteronism, is the most common secondary cause of hypertension. Primary aldosteronism is associated with an increased risk of cardiovascular disease and kidney dysfunction compared to essential hypertension. Excess aldosterone can lead to harmful metabolic and other pathophysiological alterations, as well as cause inflammatory, oxidative, and fibrotic effects in the heart, kidney, and blood vessels. These alterations can result in coronary artery disease, including ischemia and myocardial infarction, left ventricular hypertrophy, heart failure, arterial fibrillation, intracarotid intima thickening, cerebrovascular disease, and chronic kidney disease. Thus, aldosterone affects several tissues, especially in the cardiovascular system, and the metabolic and pathophysiological alterations are related to severe diseases. Therefore, understanding the effects of aldosterone on the body is important for health maintenance in hypertensive patients. In this review, we focus on currently available evidence regarding the role of aldosterone in alterations of the cardiovascular and renal systems. We also describe the risk of cardiovascular events and renal dysfunction in hyperaldosteronism.

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“…Compared to patients with essential hypertension (EH), PA patients tend to have more severe damage to the target organs, including the heart and kidneys (4,5). PA can be traced to severe glucose Original Article Diagnostic value of the fractional excretion of urine potassium for primary aldosteronism metabolism disorders (6). Early diagnosis of PA is necessary to enable clinicians to implement interventions to improve the prognosis of patients.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the fractional excretion of urine potassium for primary aldosteronism

Yuan¹,

Wang²,

Yang³

et al. 2023

Ann Transl Med

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Background Primary aldosteronism (PA) is a common form of secondary hypertension, which usually manifests low blood potassium levels. The fractional excretion of urine potassium (FEK) has been proposed as a useful tool to measure urinary potassium excretion. However, the role of the FEK in PA remains unclear. In the current study, we assessed the diagnostic value of FEK in PA. Methods A total of 155 hypertension patients were included in this cross-sectional study, of which 62 were confirmed by a positive screening test for PA. We collected the serum, 24-hr urine samples, and spot urine samples to evaluate the diagnostic value of the spot and 24-hr FEK in the diagnosis of PA and renal potassium loss compared to other indices. The sensitivity and specificity of the related diagnostic indexes were analyzed using receiver operating characteristic (ROC) curves, and the optimal cut-point value of the diagnostic index was determined according to the Youden index (YI) (sensitivity + specificity − 1). Correlation analysis was performed between the spot FEK and 24-hr FEK using Pearson’s correlation coefficient. Results The spot FEK (7.3 vs. 5.9) and 24-hr FEK (9.3 vs. 8.0) levels were statistical differences between the PA and essential hypertension groups. PA patients had a significant tendency to lose potassium through the kidneys. We found that FEK from spot urine distinguished renal potassium loss with a sensitivity of 86.7% and a specificity of 87.1% at a cut-off of 9.8%. The sensitivity and specificity of the spot FEK in screening PA were 51.6% and 76.3%, respectively. Conclusions FEK is significantly related to renal potassium loss. Spot FEK and 24-hr FEK performed a certain diagnostic value for PA, which may be potential indicators for the differential diagnosis of PA.

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Insulin sensitivity and pancreatic β-cell function in patients with primary aldosteronism

Cited by 9 publications

References 51 publications

Differences in Glycemic Abnormalities Between Primary Aldosteronism and Essential Hypertension: A Systematic Review and Meta-Analysis

Differences in Glycemic Abnormalities Between Primary Aldosteronism and Essential Hypertension: A Systematic Review and Meta-Analysis

The Effect of Aldosterone on Cardiorenal and Metabolic Systems

Diagnostic value of the fractional excretion of urine potassium for primary aldosteronism

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