Nonalcoholic Fatty Liver Disease in Primary Aldosteronism: A Pilot Study

Fallo, Francesco; Pozza, Anna; Tecchio, M.; Tona, Francesco; Sonino, Nicoletta; Ermani, Mario; Catena, Cristiana; Bertello, Chiara; Mulatero, Paolo; Sabato, Nicoletta; Fabris, Bruno; La, Sechi

doi:10.1038/ajh.2009.206

Cited by 42 publications

(26 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, in the present study, both prevalent diabetes and OGTT 2 h plasma glucose were inversely associated with serum potassium level. Recently, Fallo et al 8 have found that higher prevalence of NAFLD in hypokalemic than in normokalemic PA patients was related to their higher level of insulin resistance. Moreover, hypokalemia was the only independent predictor of NAFLD at multivariable analysis in this study.…”

Section: Discussionmentioning

confidence: 98%

“…Experimental and clinical evidence has suggested that decreased serum potassium level may contribute to various metabolic disorders, which may consequently increase the risk of NAFLD. [4][5][6][7][8] Previous studies have shown that potassium depletion, even without frank hypokalemia, can cause insulin resistance, and therapeutic interventions aimed at correcting potassium level could improve insulin sensitivity. 4,5 A meta-analysis collecting data from randomized controlled trials showed a significant inverse correlation between serum potassium level and blood glucose, while potassium supplementation could alleviate such effect.…”

Section: Introductionmentioning

confidence: 99%

“…9 Recently, high risk of prevalent metabolic and liver diseases was found in patients with primary aldosteronism (PA) and hypokalemia. 8 Compared with normokalemia PA individuals, those with potassium depletion have higher prevalence of NAFLD and more serious insulin resistance. Spironolactone and vitamin E combined therapy, which significantly increased the serum potassium level, exhibit a beneficial effect on reduction in insulin resistance in patients with NAFLD.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Low serum potassium level is associated with nonalcoholic fatty liver disease and its related metabolic disorders

Sun

Jiang

et al. 2013

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Low serum potassium level is associated with nonalcoholic fatty liver disease and its related metabolic disorders

Sun

Jiang

et al. 2013

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Various other molecules, such as circulating levels of visfatin, leptin, resistin, and aldosterone have been reported to be increased both in patients with CKD [50,51,[60][61][62] and in those with NAFLD/NASH [63][64][65][66]. Recently, some investigators have also measured circulating levels of advanced glycation endproducts (AGE) and its soluble receptors (s-RAGE) in patients with CKD and in those with NAFLD/NASH [67][68][69][70].…”

Section: Increased Incidence Of Chronic Kidney Disease In Patients Wimentioning

confidence: 96%

Risk of chronic kidney disease in patients with non-alcoholic fatty liver disease: Is there a link?

Targher

Chonchol

Zoppini

et al. 2011

Journal of Hepatology

159

131

View full text Add to dashboard Cite

Non-alcoholic fatty liver disease (NAFLD) has emerged as a growing public health problem worldwide. Increasing recognition of the importance of NAFLD and its association with the features of the metabolic syndrome has stimulated an interest in its putative role in the development and progression of chronic kidney disease (CKD). Accumulating evidence suggests that NAFLD and CKD share many important cardio-metabolic risk factors and common pathogenetic mechanisms and that NAFLD is associated with an increased prevalence and incidence of CKD. This association appears to be independent of obesity, hypertension, and other potentially confounding factors, and it occurs both in patients without diabetes and in those with diabetes. Although further research is needed to establish a definitive conclusion, these observations raise the possibility that NAFLD is not only a marker of CKD but also might play a part in the pathogenesis of CKD, possibly through the systemic release of several pro-inflammatory/pro-coagulant mediators from the steatotic/inflamed liver or through the contribution of NAFLD itself to insulin resistance and atherogenic dyslipidemia. However, given the heterogeneity and small number of observational longitudinal studies, further research is urgently required to corroborate the prognostic significance of NAFLD for the incidence of CKD, and to further elucidate the complex and intertwined mechanisms that link NAFLD and CKD. If confirmed in future large-scale prospective studies, the potential adverse impact of NAFLD on kidney disease progression will deserve particular attention, especially with respect to the implications for screening and surveillance strategies in the growing number of patients with NAFLD.

show abstract

“…9,10 The results of a recent pilot study also suggest that fatty liver, a feature strictly linked to insulin resistance, is a frequent finding in patients with PA, more markedly in those with hypokalemia. 11 The worse metabolic profile described by Somloova et al 5 in IHA than in APA is more difficult to interpret. The fact that overweight/ obesity was more represented in their IHA compared with APA patients needs to be discussed.…”

mentioning

confidence: 98%

Metabolic syndrome and primary aldosteronism: time for reappraisal?

Fallo

Sonino

2010

J Hum Hypertens

View full text Add to dashboard Cite

Recent studies have addressed the issue of an association of metabolic abnormalities with primary aldosteronism (PA). In a prospective study, we were the first to report a higher prevalence of metabolic syndrome, as defined by Adult Panel Treatment (ATP) III criteria, in a large population of patients with PA compared with patients with essential hypertension (EH) (41 vs 29%, Po0.05). 1 Distribution of each component of the metabolic syndrome showed a higher frequency of hyperglycaemia in PA than in EH, whereas there was no difference between the two populations as to blood pressure levels, abdominal obesity, body mass index and lipid levels. The occurrence of metabolic syndrome was similar in aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) subtypes. Ronconi et al. 2 confirmed a higher prevalence of the metabolic syndrome in PA compared with matched EH patients (45 vs 30%, Po0.05). Among their PA patients, the metabolic syndrome tended to be more frequent, though not significantly, in IHA than in APA (51 vs 32%). In the same line, Iacobellis et al. 3 have recently found, using the 2004 modified version of ATP III (high fasting glucose X100 mg per 100 ml), that PA was associated with metabolic syndrome more frequently than EH, and when PA subgroups were considered separately the metabolic syndrome was slightly prevalent in APA compared with IHA (29 vs 21%). The clinical relevance of all these observations is that aldosterone excess may lead to cardiovascular damage by mechanisms independent of its hypertensive effect, that is, an altered metabolic profile, suggesting that the reported higher rate of cardiovascular events in PA than in EH might be due to increased prevalence of the metabolic syndrome in the former condition. 4 However, the pathophysiology and characteristics of this association are still controversial and not fully elucidated.In this issue of the Journal of Human Hypertension, Somloova et al. 5 provide additional fuel to this matter with data on the metabolic phenotype of patients with PA, particularly as to the intriguing differences between the two main subtypes. The authors analysed retrospectively 100 patients with PA, 50 IHA and 50 APA, in comparison with 90 patients with EH matched for age and duration of hypertension. According to the 2009 International Diabetes Federation definition of the metabolic syndrome, its prevalence was similar in patients with PA and EH. Within PA and analysing metabolic syndrome individual components, fasting glucose level was similar in IHA and APA, whereas highdensity lipoprotein-cholesterol was markedly lower and body mass index and triglycerides were significantly higher in IHA than in APA. Overall, the metabolic syndrome was more prevalent in IHA than in APA (62 vs 36%, Po0.05). The results of Somloova et al. are partly in accordance with those of Matrozova et al. 6 who reported in a large controlled cross-sectional study that prevalence of carbohydrate and lipid metabolism disorders is similar in PA and in EH. However, Matrozova ...

show abstract

Nonalcoholic Fatty Liver Disease in Primary Aldosteronism: A Pilot Study

Cited by 42 publications

References 14 publications

Low serum potassium level is associated with nonalcoholic fatty liver disease and its related metabolic disorders

Low serum potassium level is associated with nonalcoholic fatty liver disease and its related metabolic disorders

Risk of chronic kidney disease in patients with non-alcoholic fatty liver disease: Is there a link?

Metabolic syndrome and primary aldosteronism: time for reappraisal?

Contact Info

Product

Resources

About