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

Abstract

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.

Association Between Renal Sinus Fat and Cardiometabolic and Renin-Angiotensin System Parameters in Primary Aldosteronism

“…We also found significant inverse relationships between RSF% and PAC and ARR in the unilateral women even after adjustment for key confounders. Our findings are consistent with previous studies that found epicardial fat thickness and visceral adipose tissue area are negatively associated with PAC and ARR in PA patients with unilateral aldosterone-producing adenoma [ 15 , 41 ]. Although the mechanism responsible for our observation of the dissociation between unilateral and bilateral groups remains unclear, it is possible that abnormally high PAC causes adipose tissue inflammation and fibrosis, leading to the inhibition of RSF expansion in unilateral PA patients [ 42 ].…”

Cardiovascular and metabolic characters of KCNJ5 somatic mutations in primary aldosteronism

“…Although APA leads to higher aldosterone secretion compared to BAH ( 98 ), several reports have revealed higher prevalence rates of MetS, obesity, and dyslipidemia in patients with BAH compared to those with APA ( 97 , 99 – 101 ). Youichi et al.…”

Association of Aldosterone, Renin, and Aldosterone to Renin Ratio with Metabolic Profile in Primary Aldosteronism

“… 8 , 9 Further studies followed, showing a correlation between renin or aldosterone-to-renin ratio (ARR) and diabetes prevalence, glucose metabolism indices, or visceral fat mass. 10 , 11 …”

“…8,9 Further studies followed, showing a correlation between renin or aldosterone-to-renin ratio (ARR) and diabetes prevalence, glucose metabolism indices, or visceral fat mass. 10,11 Collectively, the relationship between PA and distribution of body fat mass (FM), lean mass (LM) is relatively unexplored area. There is growing support for the notion that regional FM and LM are related to distinct effects on metabolic syndrome and CVD.…”