Female sex hormones are associated with the reduction of serum sodium and hypertension complications in patients with aldosterone-producing adenoma

Zhu, Xiaoli; Tang, Zhuoyue; Yang, Guoqing; Du, Jin; Wang, Xian-ling; Yang, Jin-zhi; Gu, Weijun; Guo, Qinghua; Jiang, Nan; Yang, Lijuan; Ba, Jianming; Dou, Jingtao; Mu, Yiming

doi:10.1507/endocrj.ej13-0123

Cited by 4 publications

(4 citation statements)

References 47 publications

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“…Similar data were obtained by other authors, with reported OR of hypertension cure in females vs. males ranging from 2.9 [5] to 3.7 [22]. The real reason why surgical outcomes are better in women than men is not completely understood, but it may be related to the fact that women tended to be younger [23], have less hypertension complications [24] and lower BMI [18] than males with PA. Another key factor to consider is the number of antihypertensive medications used for BP control [5,7,21]. In our cohort, patients who required less than three drugs for BP before surgery had a 2.5-fold higher chance of hypertension cure than those patients that used more drugs.…”

Section: ããsupporting

confidence: 84%

Predictive model of hypertension resolution after adrenalectomy in primary aldosteronism: the SPAIN-ALDO score

Araujo-Castro

Fano

Boillos

et al. 2022

Journal of Hypertension

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Purpose: To develop a predictive model of hypertension resolution after adrenalectomy in patients with primary aldosteronism (PA), based on their presurgical characteristics.Methods: A retrospective multicenter study of PA patients in follow-up in 20 Spanish tertiary hospitals between 2018 and 2021 was performed (SPAIN-ALDO Register). Clinical response postadrenalectomy was classified according to the primary aldosteronism surgical outcome (PASO) consensus criteria. The predictive model was developed using a multivariate logistic regression model with the estimation of all possible equations.Results: A total of 146 patients (54.8% females; mean age of 51.5 AE 10.9 years) with PA who underwent unilateral adrenalectomy were included. After a mean follow-up of 29.1 AE 30.43 months after surgery, hypertension cure was obtained in 37.7% (n ¼ 55) of the patients. The predictive model with the highest diagnostic accuracy to predict hypertension cure combined the variables female sex, use of two or fewer antihypertensive medications, hypertension grade 1, without type 2 diabetes and nonobesity. The area under the receiver operating characteristic curve of this model was 0.841 [0.769-0.914]. Based on this model, the group of patients with a higher probability of cure (80.4%) were those without type 2 diabetes, BMI <30 kg/m 2 , female sex, hypertension grade 1 and who use two or fewer antihypertensives. Our predictive model offered a slightly higher diagnostic accuracy than Wachtel's (area under the curve [AUC]: 0.809), Utsumi's (AUC: 0.804) and Zarnegar's (AUC: 0.796) models and was similar than the Burello's (AUC: 0.833) model. Conclusion:Female sex, use of two or fewer antihypertensive medications, hypertension grade 1, no type 2 diabetes and nonobesity may predict hypertension cure after adrenalectomy in patients with PA. Our score provides a potential tool to guide preoperative patient counseling.

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Section: ããsupporting

confidence: 84%

Predictive model of hypertension resolution after adrenalectomy in primary aldosteronism: the SPAIN-ALDO score

Araujo-Castro

Fano

Boillos

et al. 2022

Journal of Hypertension

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“…The SSC in women was lower than that in men up to the age of 50 years, while beyond 50 years the association even reversed. This tendency has also been previously observed (28,29). Besides, the female gender was also found to be an independent risk factor for hyponatremia (30)(31)(32).…”

Section: Discussionsupporting

confidence: 85%

“…Besides, the female gender was also found to be an independent risk factor for hyponatremia (30)(31)(32). Possible explanations for these sex-specific differences may be the impact of female sex hormones in regulating serum sodium, sex differences in regulation of arginine vasopressin, renal sodium secretion, and absorption (28,29,33,34). Interestingly, menopause among Chinese women occurs at approximately the age of 50 years, consisting with the age when the difference in SSC between women and men started to reverse.…”

Section: Discussionmentioning

confidence: 99%

Serum Sodium Concentration and Increased Risk for Primary Epiretinal Membrane

et al. 2021

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Aims: To examine the prevalence of primary epiretinal membranes (ERMs) and associated systemic factors.Methods: The cross-sectional, community-based Tongren Health Care Study enrolled participants who received regular health examinations in the Beijing Tongren Hospital from 2017 to 2019. Using fundus photographs, retinal specialists assessed the presence of ERMs and their systemic associations.Results: Primary ERMs were detected in 841/22820 individuals, with a prevalence of 3.7% [95% confidence intervals (CI): 3.4–3.9%] in the total study population (mean age: 44.5 ± 13.8 years) and 6.5% (95% CI: 6.1–7.0%) in individuals aged 40+ years. In multivariable analysis, a higher ERMs prevalence was associated with older age [odds ratio (OR): 1.10; P < 0.001], higher serum cholesterol concentration (OR: 1.14; P = 0.003) and higher serum sodium concentration (SSC) (OR: 1.12; P < 0.001). In women, a higher SSC, even within the normal range, was associated with an increased risk of ERMs (OR: 1.19; P < 0.001). Female participants with an SSC of 144–145mmol/L as compared with those with an SSC of 135–137 mmol/L had a 5-fold increased odds of having ERMs (All women: OR: 5.33; P < 0.001; Women aged 40+years: OR: 4.63; P < 0.001).Conclusion: Besides older age and higher serum cholesterol concentration, a higher SSC, even if within the normal range, was independently associated with a higher ERM prevalence in women.

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“…Therefore, we supposed that the mutation of KCNJ5 gene might exert a greater effect on the production of aldosterone manifestation of Chinese male patients. Other studies also suggested that male APA patients might have severe phenotype and more complications, 26 , 27 which may be explained by the protecting effect of estrogens and progesterones in female patients. 28 …”

Section: Discussionmentioning

confidence: 97%

Prevalence and Characterization of Somatic Mutations in Chinese Aldosterone-Producing Adenoma Patients

Wang

Zhang

et al. 2015

Medicine

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Female sex hormones are associated with the reduction of serum sodium and hypertension complications in patients with aldosterone-producing adenoma

Cited by 4 publications

References 47 publications

Predictive model of hypertension resolution after adrenalectomy in primary aldosteronism: the SPAIN-ALDO score

Predictive model of hypertension resolution after adrenalectomy in primary aldosteronism: the SPAIN-ALDO score

Serum Sodium Concentration and Increased Risk for Primary Epiretinal Membrane

Prevalence and Characterization of Somatic Mutations in Chinese Aldosterone-Producing Adenoma Patients

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