Links between aldosterone excess and metabolic complications: A comprehensive review

Bothou, Christina; Beuschlein, Felix; Spyroglou, Ariadni

doi:10.1016/j.diabet.2019.02.003

Cited by 34 publications

(29 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies reported that PA patients had a higher prevalence of MetS compared with EH (40-45 vs. 30%) (26,27). There was a positive correlation between aldosterone and TG as well as LDL levels, and a negative correlation between aldosterone and HDL (28). Thus, MetS and dyslipidemia may also be the results of PA, which coexisted with DM or then contributed to the development of DM.…”

Section: Discussionmentioning

confidence: 99%

Higher Blood Urea Nitrogen and Urinary Calcium: New Risk Factors for Diabetes Mellitus in Primary Aldosteronism Patients

et al. 2020

View full text Add to dashboard Cite

The aim of the study was to investigate the prevalence and risk factors of diabetes mellitus (DM) in primary aldosteronism (PA) patients.Methods: This case-control study enrolled 259 PA patients in West China Hospital, China from January 2016 to January 2019. Patients were divided into three groups: PA group, PA + impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) group and PA + DM group. Clinical characteristics (like age and sex) and laboratory variables (like plasma aldosterone concentration and plasma renin activity) were compared between three groups. Univariate and multivariate logistic regression analyses were performed to determine risk factors for DM in PA patients. The association of random blood glucose with the above-mentioned factors were also investigated by Pearson correlation analyses. Nomogram model was developed to predict the probability of DM in PA patients.Results: 49 (18.9%) patients were diagnosed with DM and 22 (8.5%) with IFG/IGT in 259 PA patients. Apart from older age, male, higher body mass index, higher triglycerides and lower cholesterol, we found that higher blood urea nitrogen (BUN) and higher 24 h urinary calcium (Ca) might be potential new risk factors for dysglycemia. The nomogram model for DM in PA patients had a good predictive accuracy, with the area under the curve of receiver operating characteristic of 0.839 (95% CI 0.784-0.893).Conclusions: PA patients were more likely to have DM compared with general population. Apart from older age, overweight and dyslipidemia, higher BUN and excessive excretion of urinary Ca may also be the new potential risk factors for DM in PA patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Higher Blood Urea Nitrogen and Urinary Calcium: New Risk Factors for Diabetes Mellitus in Primary Aldosteronism Patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Previous studies found that PA patients manifested less-severe abnormalities of glucose and lipid metabolism 24) but much earlier emergence of albuminuria 25) and more severe endothelial dysfunction contrary to EH patients 26) . This indicated that PA was more predisposed to prominent renal and vascular damages, especially to much earlier and more severe atherosclerosis 27,28) .…”

Section: Discussionmentioning

confidence: 88%

Beta-2-Microglobulin is an Independent Risk Factor for Asymptomatic Carotid Atherosclerosis in Patients with Primary Aldosteronism

Liang

Lai

et al. 2022

JAT

View full text Add to dashboard Cite

To identify the association between serum beta-2-microglobulin (B2M) or cystatin C (CysC) and asymptomatic carotid atherosclerosis in patients with primary aldosteronism (PA). Methods:In this cross-sectional study, 265 subjects were enrolled, including 83 patients with PA, 91 with essential hypertension (EH), and 91 normotensive (NT) controls. B2M, CysC, plasma renin activity (PRA), and plasma aldosterone concentration (PAC) were measured, and the aldosterone-to-renin ratio (ARR) was calculated. Carotid intima-media thickness (cIMT), increased cIMT, and presence of carotid plaque or carotid stenosis 50% in the carotid artery were measured via ultrasonography to evaluate the degree of asymptomatic carotid atherosclerosis.Results: CIMT increased in the NT, EH, and PA groups (0.60 (0.50, 0.80) mm vs. 0.80 (0.60, 1.00) mm vs. 0.90 (0.70, 1.10) mm, P 0.01), so as the prevalence of increased cIMT and presence of carotid plaque (both P 0.05). The B2M and CysC levels exhibited the same trend (B2M: 1.60 0.34 mg/L, 1.80 0.41 mg/L, 1.98 0.64 mg/L, P 0.05; CysC: 0.76 0.12 mg/L, 0.88 0.17 mg/L, 0.94 0.23 mg/L, P 0.05). B2M, CysC, PAC, and ARR were all positively associated with cIMT (all P 0.01) in the PA group. After adjusting for potential confounders, B2M, PAC, but not CysC or ARR were independently associated with increased cIMT and presence of carotid plaque and carotid stenosis 50%, respectively. The receiver operating characteristic (ROC) curve analysis revealed that B2M and PAC demonstrated significant predictive ability for increased cIMT and presence of carotid plaque and carotid stenosis 50%. Conclusion:B2M is an independent risk factor for asymptomatic carotid atherosclerosis in patients with PA. and 17%-23% in resistant hypertension 3) . Compared with essential hypertension (EH), long-term exposure to increased aldosterone levels may lead to renal, cardiac, and vascular injury, which eventually results in the significant increase in the morbidity and mortality rates due to arteriosclerotic cardiovascular

show abstract

“…Evidence continues to accrue confirming chronic Ang II/aldosterone/MR hyper-activation in several cardiovascular disorders, including hypertension, coronary artery disease, ventricular hypertrophy, atrial fibrillation, congestive heart failure and related diseases such as chronic kidney disease, diabetes, stroke and Metabolic Syndrome. (13) In these disease settings the affected tissues are in a heightened state of oxidative and inflammatory stress with persistent interactive up-regulation promoting disease progression. The homeostatic response to chronic RAAS stress is up-regulation of ACE2 and atrial and brain natriuretic factors.…”

Section: The Mineralocorticoid Receptor (Mr)mentioning

confidence: 99%

The Central Role of the Aldosterone in COVID-19 Provides a Treatment Target.

Henry

2020

Preprint

View full text Add to dashboard Cite

Striking features of the COVID-19 pandemic are the rapid spread of the SARS-CoV-2 virus and the relatively narrow profile of patients adversely affected. SARS-CoV-2 enters human cells by means of ACE2, destroying the protein in the process. ACE2 maintains renin-angiotensin-aldosterone system (RAAS) homeostasis and is upregulated in the setting of chronic RAAS disequilibrium seen in COVID-19-susceptible patients. The ACE2-depletion effect on angiotensin II (AngII) levels likely contributes to the spectrum of cytokine responses found in COVID-19 patients. However, as most of the inflammatory effects of AngII are amplified through aldosterone-activated mineralocorticoid receptors (MRs), blocking MRs may provide much-needed benefit. The MR-blockers, spironolactone and eplerenone, are relatively selective in exerting downstream dampening effects on RAAS stress and target the pathophysiological processes in COVID-19-susceptible patients where acute viral-induced ACE2 depletion could be responsible for a catastrophic aldosterone surge in severely ill patients.

show abstract

Links between aldosterone excess and metabolic complications: A comprehensive review

Cited by 34 publications

References 74 publications

Higher Blood Urea Nitrogen and Urinary Calcium: New Risk Factors for Diabetes Mellitus in Primary Aldosteronism Patients

Higher Blood Urea Nitrogen and Urinary Calcium: New Risk Factors for Diabetes Mellitus in Primary Aldosteronism Patients

Beta-2-Microglobulin is an Independent Risk Factor for Asymptomatic Carotid Atherosclerosis in Patients with Primary Aldosteronism

The Central Role of the Aldosterone in COVID-19 Provides a Treatment Target.

Contact Info

Product

Resources

About