Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Er, Leay Kiaw; Lin, Yen-Hung; Tsai, Yao Chou; Hsiao, Jong‐Kai; Yang, Chin‐Yi; Chang, Chin Chen; Peng, Kang-Yung; Chueh, Shih-Chieh; Wu, Vin-Cent

doi:10.1136/bmjdrc-2019-001153

Cited by 13 publications

(11 citation statements)

References 48 publications

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“…In the present study, ARR was significantly negatively correlated with VAT area, VAT ratio, WC, and BMI in patients with APA. These findings were consistent with Er et al, who indicated that patients with APA had relatively smaller abdominal fat distribution, but the VAT will be increased after unilateral adrenalectomy (32). However, relevant study is still sparse, and the exact pathomechanisms remain clarified in the future.…”

Section: Discussionsupporting

confidence: 90%

“…Cortisol hypersecretion can be associated with obesity. Second, we did not evaluate laboratory data, such as lipid profile and HOMA-IR index, but these data have been proven to be irrelevant to abdominal fat accumulation (32). Third, this retrospective study did not take the effects of relevant medication history into account, such as antihypertensives or statins.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Abdominal Computed Tomography Scans for Differentiating the Discrepancies in Abdominal Adipose Tissue Between Two Major Subtypes of Primary Aldosteronism

et al. 2021

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The aim of this study was to analyze the differences in the distribution of abdominal adipose tissue between the two subtypes of primary aldosteronism (PA) using abdominal computed tomography. We retrospectively analyzed patients diagnosed as having essential hypertension (EH) or PA from the prospectively collected Taiwan Primary Aldosteronism Investigation (TAIPAI) database. Patients with PA were divided into the subgroups of idiopathic hyperaldosteronism (IHA) and unilateral aldosterone-producing adenoma (APA). Patients’ basic clinicodemographic data were collected, and a self-developed CT-based software program was used to quantify the abdominal adiposity indexes, including visceral adipose tissue (VAT) area, VAT ratio, waist circumference (WC), subcutaneous adipose tissue (SAT) area, and SAT ratio. We included 190 patients with EH and 436 patients with PA (238 with IHA and 198 with APA). The APA group had significantly lower abdominal adiposity indexes than the other groups. We also found negative correlations of aldosterone-to-renin ratio (ARR) with VAT area, VAT ratio, WC, and body mass index (BMI) in the APA group. After propensity score matching (which left 184 patients each in the IHA and APA groups), patients in the APA group still had significantly lower WC, SAT area, SAT ratio, and VAT ratio than those in the IHA group. Furthermore, logistic regression analysis indicated that lower probability of abdominal obesity was significantly related to patients with APA. Our data revealed that the distribution of abdominal adipose tissue was similar in patients with IHA and those with EH, but the abdominal adiposity indexes were significantly lower in patients with APA than in those with IHA and EH.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Evaluation of Abdominal Computed Tomography Scans for Differentiating the Discrepancies in Abdominal Adipose Tissue Between Two Major Subtypes of Primary Aldosteronism

et al. 2021

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“…A similar study of patients with primary aldosteronism suggested that worsening HDL-C and triglyceride levels were associated with decreased renal function postadrenalectomy, whereas only triglyceride elevation occurred postoperatively in patients with primary aldosteronism without renal impairment (eGFR >60 ml/min per 1.73 m 2 ) [16,34]. Er et al [17] reported that postadrenalectomy, improvement in excessive secretion of aldosterone in patients with APA patients resulted in an increase in visceral fat. It may be hypothesized that the adipocyte RAS has a compensatory effect postadrenalectomy, as the abrupt drop in aldosterone levels leads to overactivation of both systemic and adipocyte RAS activity.…”

Section: Discussionmentioning

confidence: 95%

Aldosterone-producing adenoma-harbouring KCNJ5 mutations is associated with lower prevalence of metabolic disorders and abdominal obesity

Chen

Chang

et al. 2021

Journal of Hypertension

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Yen-Hung Lin g , on behalf of the TAIPAI Study Group Objective: Aldosterone overproduction and lipid metabolic disturbances between idiopathic hyperaldosteronism (IHA) and unilateral aldosterone-producing adenoma (APA) have been inconsistently linked in patients with primary aldosteronism. Moreover, KCNJ5 mutations are prevalent among APAs and enhance aldosterone synthesis in adrenal cortex. We aimed to investigate the prevalence of metabolic syndrome (MetS) in each primary aldosteronism subtype and observe the role of KCNJ5 mutations among APAs on the distribution of abdominal adipose tissues quantified using computed tomography (CT), including their changes postadrenalectomy.Design and methods: We retrospectively collected 244 and 177 patients with IHA and APA at baseline. Patients with APA had undergone adrenalectomy, and gene sequencing revealed the absence (n ¼ 75) and presence (n ¼ 102) of KCNJ5 mutations. We also recruited 31 patients with APA who had undergone CT-scan 1-year postadrenalectomy.Results: The patients with APA harbouring KCNJ5 mutations had significantly lower prevalence of MetS and smaller distribution in waist circumference, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) than the other groups. Logistic regression analysis indicated that the VAT area correlated significantly with KCNJ5 mutations among the APAs. Only participants with KCNJ5 mutations had significant increases in triglycerides, cholesterol, SAT, and VAT after 1-year postadrenalectomy. Conclusion:This study is the first to demonstrate that MetS and abdominal obesity were less prevalent in the patients with APA harbouring KCNJ5 mutations compared with the IHA group and the non-KCNJ5-mutated APA group. Increasing prevalence of dyslipidaemia and abdominal obesity was observed in patients with KCNJ5 mutations 1-year postadrenalectomy.

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“…In a previous report, VFA and PAC were correlated in patients with idiopathic hyperaldosteronism [ 47 ]. One report showed that VFA was significantly lower in an aldosterone-producing adenoma (APA) group than in patients with EH [ 48 ]. However, the association between the levels of renin-aldosterone activity and those of VF tissue accumulation remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Association of the ratio of visceral-to-subcutaneous fat volume with renal function among patients with primary aldosteronism

et al. 2021

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Patients with primary aldosteronism have a higher risk of chronic kidney disease. Visceral fat tissue is hypothesized to stimulate the adrenal glands to overproduce aldosterone, and aldosterone promotes visceral fat tissue to produce inflammatory cytokines. However, it is unclear whether the volume of accumulated visceral fat tissue is associated with renal impairment among patients with hyperaldosteronism. We conducted a single-center cross-sectional study to assess the association between the estimated glomerular filtration rate and the ratio of the visceral-to-subcutaneous fat volume calculated by computed tomography. One hundred eighty patients with primary aldosteronism were enrolled. The mean ± SD age was 52.7 ± 11.0 years, and 60.0% were women. The ratio of visceral-to-subcutaneous fat volume was highly correlated with the estimated glomerular filtration rate (r = 0.49, p < 0.001). In multiple linear regression models, the ratio of visceral-to-subcutaneous fat tissue volume was significantly associated with the estimated glomerular filtration rate (estimates: −4.56 mL/min/1.73 m² per 1-SD), and there was an interaction effect between the plasma aldosterone concentration and the ratio of visceral-to-subcutaneous fat volume (p < 0.05). The group with a higher plasma aldosterone concentration exhibited a steeper decline in eGFR than the lower plasma aldosterone concentration group when the ratio increased. The ratio of visceral-to-subcutaneous fat tissue volume was an independent risk factor for renal dysfunction. This association increased in the presence of a high plasma aldosterone concentration. Clinicians should pay attention to the ratio of visceral-to-subcutaneous fat tissue volume and encourage primary aldosteronism patients to improve their lifestyle in addition to treating renin-aldosterone activity.

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Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Cited by 13 publications

References 48 publications

Evaluation of Abdominal Computed Tomography Scans for Differentiating the Discrepancies in Abdominal Adipose Tissue Between Two Major Subtypes of Primary Aldosteronism

Evaluation of Abdominal Computed Tomography Scans for Differentiating the Discrepancies in Abdominal Adipose Tissue Between Two Major Subtypes of Primary Aldosteronism

Aldosterone-producing adenoma-harbouring KCNJ5 mutations is associated with lower prevalence of metabolic disorders and abdominal obesity

Association of the ratio of visceral-to-subcutaneous fat volume with renal function among patients with primary aldosteronism

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