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

Shibayama, Yuki; Wada, Norio; Baba, Shuhei; Miyano, Yukie; Obara, Shin’ya; Iwasaki, Ren; Nakajima, H; Sakai, Hiromu; Usubuchi, Hiroaki; Terae, Satoshi; Nakamura, Akinobu; Atsumi, Tatsuya

doi:10.1210/js.2018-00187

Cited by 22 publications

(20 citation statements)

References 33 publications

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“…This speculation might explain why our result showed longer term of excess aldosterone in patients with APA presented with smaller VFA. Among the population of non-PA, one study found the positive correlation between serum aldosterone levels and visceral obesity in healthy women 14 ; however, other studies from a large communitybased sample of non-PA patients 36 and a recent study of APA patients, 37 in agreement with our result, reveal that visceral adipose tissue was not associated with plasma aldosterone levels.…”

Section: Discussionsupporting

confidence: 90%

Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Lin

Tsai

et al. 2020

BMJ Open Diab Res Care

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IntroductionPrimary aldosteronism (PA) is a common form of secondary hypertension that has significant cardiovascular events and increased prevalence of metabolic syndrome and diabetics. Although plasma aldosterone concentration is positively correlated with visceral fat area (VFA) in non-PA individuals, the role of visceral adiposity associated with clinical success after surgery is not known.Research design and methodsWe analyzed patients who underwent adrenalectomy for aldosterone-producing adenoma (APA) at the Taiwan PA Investigator group. VFA was calculated from the abdominal CT scan at APA diagnosis, and all patients received adrenalectomy.ResultsThe study involved 100 consecutive patients with APA (42 males; mean age 49.3 years) matched with 41 essential hypertension (EH) patients. Patients with APA had smaller VFA (p=0.010) than their EH counterparts. Multiple linear regression analysis revealed that the duration of hypertension (p=0.007), but not plasma aldosterone, was negatively correlated with VFA in patients with APA. Logistic regression analysis showed that log VFA (OR=0.065, p<0.001) and duration of hypertension before PA diagnosis (OR=0.919, p=0.011) can predict complete clinical success after adrenalectomy. Multifactor-adjusted generalized additive model demonstrated that log VFA <9.2 was associated with complete cure of hypertension. Furthermore, VFA was increased at 6 months after adrenalectomy (p=0.045).ConclusionsPatients with APA had smaller VFA than their EH counterparts, and VFA increased after adrenalectomy. Clinical complete cure of hypertension after surgery was associated with smaller VFA and shorter duration of hypertension at PA diagnosis, suggesting a potential interplay of visceral adiposity and aldosterone of the patients with APA.

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Section: Discussionsupporting

confidence: 90%

Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Lin

Tsai

et al. 2020

BMJ Open Diab Res Care

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“…Indeed, obesity has been suggested to induce hyperaldosteronism through the actions of adipocytokines; for example, activation of the sympathetic nervous system 10 . Shibayama et al 34 reported that there was a positive association between PAC and visceral fat area in patients with IHA. In the present study, as shown in the lower Matsuda index, insulin sensitivity was lower in IHA compared with APA with no difference in the presence of either obesity or central obesity.…”

Section: Discussionmentioning

confidence: 99%

Different pathogenesis of glucose intolerance in two subtypes of primary aldosteronism: Aldosterone‐producing adenoma and idiopathic hyperaldosteronism

Okazaki-Hada

Moriya

Nagao

et al. 2020

J of Diabetes Invest

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Aims/Introduction An increased risk of diabetes mellitus has been reported in primary aldosteronism, but the pathogenesis of glucose intolerance between the primary aldosteronism subtypes remains unclear. This study aimed to evaluate glucose metabolism in oral glucose tolerance test between aldosterone‐producing adenoma and idiopathic hyperaldosteronism, and characterize patients with improved glucose intolerance after primary aldosteronism treatment. Materials and Methods Oral glucose tolerance test was carried out in 116 patients who were diagnosed with primary aldosteronism and received adrenal venous sampling for subtyping. Oral glucose tolerance test was re‐evaluated after starting the treatment of primary aldosteronism for those who had glucose intolerance before the treatment. Results A total of 46.4% and 52.3% of patients with aldosterone‐producing adenoma and idiopathic hyperaldosteronism, respectively, were diagnosed with impaired glucose tolerance or diabetes. The insulinogenic index was significantly lower in aldosterone‐producing adenoma than in idiopathic hyperaldosteronism ( P = 0.045), whereas the Matsuda insulin sensitivity index was significantly higher in aldosterone‐producing adenoma than in idiopathic hyperaldosteronism ( P = 0.022). After the treatment of primary aldosteronism, glucose intolerance was improved in 66.6% and 45.8% of aldosterone‐producing adenoma and idiopathic hyperaldosteronism, respectively. The presence of obesity and central obesity were significantly lower in patients who improved glucose intolerance after the treatment of primary aldosteronism as compared with those not improved ( P = 0.013 and P = 0.033, respectively). Conclusions Insulin secretion impairment and insulin resistance play pathogenic roles for glucose intolerance in aldosterone‐producing adenoma and idiopathic hyperaldosteronism, respectively. In addition, primary aldosteronism treatments can ameliorate glucose intolerance more effectively in patients without obesity and/or central obesity.

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“…The multivariate regression analysis showed that VF% and VFA are significantly associated with L/S ratio in patients with IHA, whereas PAC is not. We have previously reported that PAC is positively correlated with VF% and VFA in patients with IHA, but not in APA [25]. This may be because the univariate analysis, which showed a negative correlation between L/S ratio and PAC in patients with IHA, is influenced by visceral fat volume as a confounding variable.…”

Section: Discussionmentioning

confidence: 85%

The risk factors for hepatic steatosis in patients with primary aldosteronism

et al. 2020

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Patients with primary aldosteronism (PA) are complicated by metabolic syndrome more frequently than those without PA. Hyperaldosteronism has been reported to be associated with a higher prevalence of non-alcoholic fatty liver disease (NAFLD). We aimed to clarify the risk factors for hepatic steatosis in the two subtypes of PA, comparing the status of hepatic steatosis in each of these subtypes. This was a retrospective observational study. We enrolled patients with an aldosterone producing adenoma (APA) (n = 33) or idiopathic hyperaldosteronism (IHA) (n = 56). Hepatic fat content was evaluated using the ratio of liver to spleen (L/S) X-ray attenuation on unenhanced computed tomography. L/S ratio <1.0 was utilized for assessing as hepatic steatosis. Age, sex distribution, visceral fat percentage (VF%), and visceral fat area (VFA) did not differ between patients with the two PA subtypes. The percentages of patients with L/S ratio <1.0 was not different between the two subtypes (APA: 21.2 % (7/33) vs. IHA: 19.6 % (11/56), p = 1.00). In both subtypes, the L/S ratio negatively correlated with VF% (APA: r = -0.66, p < 0.001; IHA: r = -0.66, p < 0.001) and with VFA (APA: r = -0.44, p < 0.01; IHA: r = -0.37, p < 0.01). The status of hepatic steatosis, evaluated using L/S ratio, did not differ between patients with APA or IHA. Hepatic steatosis was affected by the amount of visceral fat.

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

Cited by 22 publications

References 33 publications

Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Different pathogenesis of glucose intolerance in two subtypes of primary aldosteronism: Aldosterone‐producing adenoma and idiopathic hyperaldosteronism

The risk factors for hepatic steatosis in patients with primary aldosteronism

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