A possible association between primary aldosteronism and a lower β-cell function

Mosso, Lorena; Carvajal, Cristián A.; Maíz, Alberto; Ortiz, Eugenia H; Castillo, C.; Artigas, Rocío; Fardella, Carlos E.

doi:10.1097/hjh.0b013e3282861fa4

Cited by 86 publications

(56 citation statements)

References 32 publications

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“…However, the findings are inconsistent (12,13,14,15,16,18,19,21). Two smaller studies (nZ24 (14) and 63 subjects (15)) and one large study (nZ1823 subjects (21)) reported no association between PA and glucose metabolism (including insulin sensitivity index, HOMA, or quantitative insulin sensitivity check index (QUICKI).…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies have described abnormalities in glucose homeostasis and metabolism in patients with PA (12,13,14,15,16,17,18,19,20,21,22); however, they often showed inconsistent results due to limitations in sample size, lacking of a matched control group, or nonstandardized diagnosis of PA. Nevertheless, there is growing evidence that aldosterone is involved in the pathogenesis of insulin resistance and MetS (23,24).…”

Section: Introductionmentioning

confidence: 99%

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Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn's Registry

Hanslik¹,

Wallaschofski²,

Dietz³

et al. 2015

European Journal of Endocrinology

118

100

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Design: Abnormalities in glucose homeostasis have been described in patients with primary aldosteronism (PA) but most studies show inconsistent results. Therefore, we aimed to compare the prevalence of type 2 diabetes mellitus and metabolic syndrome (MetS) in newly diagnosed PA patients to a matched control cohort of the background population. Methods: In total, 305 PA patients of the prospective German Conn's Registry were compared to the population-based Study of Health In Pomerania (SHIP1; nZ2454). A 1:1 match regarding sex, age, and BMI resulted in 269 matched pairs regarding type 2 diabetes and 183 matched pairs regarding MetS. Of the total, 153 PA patients underwent oral glucose tolerance testing (OGTT) at diagnosis and 38 PA patients were reevaluated at follow-up. Results: Type 2 diabetes and MetS were significantly more frequent in PA patients than in the control population (17.2% vs 10.4%, PZ0.03; 56.8% vs 44.8%, PZ0.02 respectively). Also, HbA1c levels were higher in PA patients than in controls (P!0.01). Of the total, 35.3% of non-diabetic PA patients showed an abnormal OGTT ( 1 ⁄ 4 newly diagnosed type 2 diabetes and 3 ⁄ 4 impaired glucose tolerance). PA patients with an abnormal OGTT at baseline presented with significantly improved 2 h OGTT glucose (PZ0.01) at follow-up. We detected a negative correlation between 2 h OGTT glucose levels and serum potassium (P!0.01). Conclusions: Type 2 diabetes and MetS are more prevalent in patients with PA than in controls matched for sex, age, BMI, and blood pressure. This may explain in part the increased cardiovascular disease morbidity and mortality in PA patients.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn's Registry

Hanslik¹,

Wallaschofski²,

Dietz³

et al. 2015

European Journal of Endocrinology

118

100

View full text Add to dashboard Cite

show abstract

“…Some reports found no difference in fasting plasma glucose levels or in the prevalence of diabetes mellitus between cases with PA and controls with essential hypertension, 14,15 whereas others found a higher prevalence of hyperglycemia or diabetes mellitus in cases with PA than in essential hypertensive controls. 16,17 These reports were based on the assessment of 14 to 85 patients with PA, generally without discriminating between PA subtypes, and used various definitions of glucose metabolism disorders. In our large, cross-sectional study involving more patients with PA than the total of these previous studies, we found no statistically significant or The numbers of patients available for analysis (No.)…”

Section: Discussionmentioning

confidence: 99%

Fasting Plasma Glucose and Serum Lipids in Patients With Primary Aldosteronism

et al. 2009

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Abstract-An association between primary aldosteronism and metabolism disorders has been reported. The aim of this retrospective study was to test for this association by comparison between large cohorts of patients with primary aldosteronism and with essential hypertension. We retrieved the records of 460 cases with primary aldosteronism (103 lateralized, 150 not lateralized, and 207 undetermined) and of 1363 controls with essential hypertension individually matched for age and sex. We compared clinical history; blood pressure levels; body mass index; levels of fasting plasma glucose and serum triglycerides; total, high-density lipoprotein, and low-density lipoprotein cholesterol; and the prevalence of diabetes mellitus and impaired fasting glucose among subtypes of primary aldosteronism, as well as between cases with primary aldosteronism and their matched controls. Fasting plasma glucose and serum lipid levels did not differ among the 3 subtypes of primary aldosteronism. The prevalence of impaired fasting glucose was lower in patients with primary aldosteronism than their matched controls, but the prevalence of hyperglycemia (impaired fasting glucose or diabetes mellitus) and blood levels of glucose and lipids did not differ between cases and controls.There was no significant difference between preoperative and postoperative levels of either fasting plasma glucose or serum lipids in patients who underwent adrenalectomy and had follow-up data available. The analysis of this large group of patients with primary aldosteronism and essential hypertension does not confirm a higher prevalence of carbohydrate or lipid metabolism disorders in the former. It is unlikely that the prevalence of metabolic syndrome differs significantly between patients with primary aldosteronism and those with essential hypertension. Key Words: diabetes mellitus Ⅲ hyperaldosteronism Ⅲ primary Ⅲ hyperlipidemia Ⅲ hypertension, essential P rimary aldosteronism (PA) is the most frequent form of endocrine hypertension. 1 Patients with PA have a higher prevalence of cardiovascular 2-5 and renal 6,7 complications than patients with essential hypertension with similar levels of blood pressure; this suggests that excess aldosterone has harmful nonhemodynamic cardiovascular and renal effects. 8,9 An association between PA and carbohydrate metabolism disorders was reported by Conn as long ago as 1965, 10 and aldosterone-producing adenoma is mentioned as a possible cause for diabetes mellitus by the American Diabetes Association. 11 A higher prevalence of metabolic abnormalities, like impaired glucose and lipid metabolism or the metabolic syndrome, might contribute to the higher cardiovascular and renal risk in patients with PA than in patients with essential hypertension. Several mechanisms for glucose and lipid metabolism impairments in PA have been discussed, including a diabetogenic effect of hypokalemia and effects of aldosterone on the insulin receptor or on adipose tissue metabolism. 12,13 However, previous studies of the prevalence of glucose ...

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“…Several studies have reported a higher prevalence of the metabolic syndrome in PA patients compared with essential hypertensive patients (76,77), with the prevalence of the metabolic syndrome and increased BMI being greater in BAH than in APA (76). Impaired glucose metabolism and increased insulin resistance, which correlate with aldosterone levels, have also been reported (76,78). Investigation of 338 patients with PA from the German Conn's registry showed a higher prevalence of diabetes mellitus in patients with PA than in hypertensive controls (79).…”

Section: Pathological Consequences Of Mineralocorticoid Excess Beyondmentioning

confidence: 92%

Genetics in endocrinology: Genetics of mineralocorticoid excess: an update for clinicians

Zennaro

Rickard

Boulkroun

2013

European Journal of Endocrinology

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Aldosterone plays a major role in the regulation of sodium and potassium homeostasis and blood pressure. More recently, aldosterone has emerged as a key hormone mediating end organ damage. In extreme cases, dysregulated aldosterone production leads to primary aldosteronism (PA), the most common form of secondary hypertension. However, even within the physiological range, high levels of aldosterone are associated with an increased risk of developing hypertension over time. PA represents the most common and curable form of hypertension, with a prevalence that increases with the severity of hypertension. Although genetic causes underlying glucocorticoid-remediable aldosteronism, one of the three Mendelian forms of PA, were established some time ago, somatic and inherited mutations in the potassium channel GIRK4 have only recently been implicated in the formation of aldosteroneproducing adenoma (APA) and in familial hyperaldosteronism type 3. Moreover, recent findings have shown somatic mutations in two additional genes, involved in maintaining intracellular ionic homeostasis and cell membrane potential, in a subset of APAs.This review summarizes our current knowledge on the genetic determinants that contribute to variations in plasma aldosterone and renin levels in the general population and the genetics of familial and sporadic PA. Various animal models that have significantly improved our understanding of the pathophysiology of excess aldosterone production are also discussed. Finally, we outline the cardiovascular, renal, and metabolic consequences of mineralocorticoid excess beyond blood pressure regulation.European Journal of Endocrinology 169 R15-R25

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A possible association between primary aldosteronism and a lower β-cell function

Cited by 86 publications

References 32 publications

Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn's Registry

Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn's Registry

Fasting Plasma Glucose and Serum Lipids in Patients With Primary Aldosteronism

Genetics in endocrinology: Genetics of mineralocorticoid excess: an update for clinicians

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