Obesity and the diagnostic accuracy for primary aldosteronism

Tirosh, Amit; Hannah‐Shmouni, Fady; Lyssikatos, Charalampos; Belyavskaya, Elena; Zilbermint, Mihail; Abraham, Smita Baid; Lodish, Maya; Stratakis, Constantine A.

doi:10.1111/jch.13041

Cited by 10 publications

(8 citation statements)

References 34 publications

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“…Goodfriend et al [ 9 ] reported a positive correlation between PAC and VFA in women with obesity without PA and in those with essential hypertension. Tirosh et al [ 26 ] reported a positive quadratic (U-shaped) correlation between PAC and BMI, not only in non-PA patients, but also in those with PA. Considering those reports, the relationship has remained unclear between PAC and BMI, waist circumference, and visceral fat in patients with PA.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Shibayama

Wada

Baba

et al. 2018

Journal of the Endocrine Society

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ContextThe involvement of visceral fat in aldosterone secretion has not been reported in patients with primary aldosteronism (PA). Patients with PA are complicated by metabolic syndrome more frequently than those without PA. An excess of visceral fat has been hypothesized to cause an elevation of aldosterone secretion in patients with PA.ObjectivesTo clarify the role of visceral fat in the pathophysiology of PA, we investigated the correlation between plasma aldosterone concentration (PAC) and visceral fat parameters in patients with PA.DesignThis retrospective observational study comprised 131 patients diagnosed with PA between April 2007 and April 2017 at Sapporo City General Hospital. We divided participants into two PA subtypes, aldosterone-producing adenoma (APA; n = 47) and idiopathic hyperaldosteronism (IHA, n = 84), utilizing adrenal venous sampling. We analyzed the correlations of PAC with visceral fat percentage (VF%), visceral fat area (VFA), and subcutaneous fat area, by evaluating computed tomography studies in each subtype group.ResultsPatients with IHA showed a positive correlation of PAC with VF% (r = 0.377, P < 0.001) and VFA (r = 0.443, P < 0.001). The correlation was not evident in patients with APA.ConclusionsThis study revealed a relationship between visceral adipose tissue and aldosterone production only in patients with IHA.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Shibayama

Wada

Baba

et al. 2018

Journal of the Endocrine Society

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“…In a large cohort of newly diagnosed hypertensive patients, in whom treatment with a calcium channel blocker, an alpha-adrenoceptor blocker or their combination was permitted, Rossi et al 6 found that despite a positive association between BMI and plasma aldosterone levels, in particular in overweight and obese individuals, the ARR did not correlate with BMI. The latter was also true in a smaller, prospective study (n = 59) in patients suspected of having PA. 11 In that study, the ARR accuracy was higher in patients with BMI <30 compared with obese patients, when using values >20 as the ARR cutoff point. It should be noted that when antihypertensive treatment could not be safely withheld, patients could not only be treated with verapamil, doxazosin, and terazosin but also with hydralazine, a drug with a well-known stimulating effect on the renin-angiotensin-aldosterone system.…”

Section: Body Mass Indexmentioning

confidence: 76%

Confounders of the aldosterone‐to‐renin ratio when used as a screening test in hypertensive patients: A critical analysis of the literature

Veldhuizen

Alnazer

Kroon

et al. 2020

J of Clinical Hypertension

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The aldosterone-to-renin ratio (ARR) is a common screening test for primary aldosteronism in hypertensives. However, there are many factors which could confound the ARR test result and reduce the accuracy of this test. The present review's objective is to identify these factors and to describe to what extent they affect the ARR. Our analysis revealed that sex, age, posture, and sodium-intake influence the ARR, whereas assay techniques do not. Race and body mass index have an uncertain effect on the ARR. We conclude that several factors can affect the ARR. Not taking these factors into account could lead to misinterpretation of the ARR. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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“…One study in PA patients reported a U-shaped correlation between PAC and BMI [ 26 ]. However, a study by Rossi et al found no significant correlation between BMI and PAC [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

High body fat percentage is associated with primary aldosteronism: a cross-sectional study

Manosroi

Atthakomol

2020

BMC Endocr Disord

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Background Excess aldosterone has been shown to be associated with obesity; however, there is currently a lack of data regarding the relationship between percentage of body fat and primary aldosteronism (PA), particularly pertaining to Asian populations. Furthermore, essential hypertension may mimic the condition of PA and there needs to be differentiation between the two. This study aimed to assess the association between percentage of body fat and PA. Methods A cross-sectional study was conducted in the outpatient department of the Endocrine and Metabolism Unit of the tertiary care medical center in Thailand. Data was obtained from 79 patients who had been screened for PA due to hypertension in young-onset, hypokalemia, adrenal incidentaloma or resistance hypertension. Essential hypertension was defined as patients who had high blood pressure and were negative for PA screening. Body fat percentage was assessed by bioelectrical impedance analysis. The relationship between percentage of body fat and a diagnosis of PA was assessed using logistic regression analysis, including adjustment for confounding factors. Results The participants were divided into a PA group (n = 41) and an essential hypertension group (n = 38). After controlling for confounding variables (age, sex, body mass index, cholesterol and insulin resistance status), the odds ratio of having PA in males with a percentage of body fat > 25% and females with percentage > 30% was 1.82 (95%CI = 1.79–1.86, p < 0.001). Conclusion A higher percentage of body fat is associated with an increased risk of PA. Further studies need to be conducted to confirm the relationship between body fat percentage and PA.

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Obesity and the diagnostic accuracy for primary aldosteronism

Cited by 10 publications

References 34 publications

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Confounders of the aldosterone‐to‐renin ratio when used as a screening test in hypertensive patients: A critical analysis of the literature

High body fat percentage is associated with primary aldosteronism: a cross-sectional study

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