The effect of aldosterone on glucose metabolism

Corry, Dalila B.; Tuck, Michael L.

doi:10.1007/s11906-003-0065-2

Cited by 86 publications

(67 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…in 20,21). It was initially thought that the cause leading to glucose intolerance in conditions characterized by increased plasma aldosterone, such as primary aldosteronism, is potassium depletion, which could modulate both pancreatic insulin secretion and insulin receptor function (22,23).…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance and Hyperinsulinemia Are Related to Plasma Aldosterone Levels in Hypertensive Patients

et al. 2007

View full text Add to dashboard Cite

OBJECTIVE -An association between aldosterone and insulin resistance has been demonstrated in obesity and primary aldosteronism and in blacks with the metabolic syndrome. The aim of this study was to evaluate the relationship of plasma aldosterone with insulin sensitivity in white subjects. RESEARCH DESIGN AND METHODS -In 356 patients with essential hypertensionand 102 normotensive control subjects of comparable age and BMI, we measured, after discontinuation of treatment, plasma active renin, aldosterone, cortisol, glucose, insulin, and C-peptide levels and calculated markers of insulin sensitivity. Direct assessment of insulin sensitivity was obtained in a subset of 64 hypertensive patients by a hyperinsulinemic clamp.RESULTS -Hypertensive patients had significantly greater fasting plasma insulin and Cpeptide concentrations and homeostasis model assessment (HOMA) indexes than normotensive control subjects. A positive association with increasing plasma aldosterone concentrations was demonstrated for plasma glucose, insulin, C-peptides, and HOMA. Assessment of insulin sensitivity by clamp showed a significant decrease of the metabolic clearance rate of glucose with increasing aldosterone levels. Significant correlations were found between plasma aldosterone, plasma insulin, and C-peptide levels, HOMA, and glucose metabolic clearance rate. Blood pressure and plasma potassium, plasma cortisol, and renin levels, but not BMI, were also directly correlated with plasma aldosterone. Multiple regression analysis showed that HOMA, together with plasma potassium, cortisol, and renin levels, was independently correlated with plasma aldosterone.CONCLUSIONS -This study demonstrates a direct relationship between aldosterone, insulin resistance, and hyperinsulinemia in white subjects. In patients with hypertension, this relationship might contribute to maintenance of high blood pressure and increased cardiovascular risk. Diabetes Care 30:2349-2354, 2007S eminal studies that were published Ͼ20 years ago demonstrated an association between hyperinsulinemia, insulin resistance, and arterial hypertension (1,2). This association was confirmed even after adjustment for body weight and was present in whites but not in blacks (3). Population-based studies have subsequently suggested that insulin resistance and hyperinsulinemia might contribute to progression of cardiovascular disease (4).Elevated plasma aldosterone levels have been implicated in the development and maintenance of high blood pressure in different ethnic groups (5), with a relationship that is stronger in blacks (5) and in obese subjects (6). In the Framingham Offspring Study, normotensive subjects with elevated plasma aldosterone levels, albeit within the normal range, were at high risk of blood pressure elevation and subsequent development of hypertension (7). Moreover, recent evidence indicates that chronic exposure to elevated aldosterone levels might result in substantial damage of the heart and blood vessels. This damage appears to be independent of the blood pres...

show abstract

Section: Discussionmentioning

confidence: 99%

Insulin Resistance and Hyperinsulinemia Are Related to Plasma Aldosterone Levels in Hypertensive Patients

et al. 2007

View full text Add to dashboard Cite

show abstract

“…In the last few years, several studies highlighted the negative effects of aldosterone excess on the heart, the blood vessels, the kidney, and the brain (4,5), as well as on the glucose metabolism and insulin sensitivity (6,7), indicating the need for a prompt diagnosis of PA and a correct therapeutic approach. While the treatment of choice for APA is unilateral adrenalectomy (8,9), medical therapy is the best treatment for idiopathic hyperaldosteronism due to adrenal hyperplasia (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Small tumor size as favorable prognostic factor after adrenalectomy in Conn's adenoma

Giacchetti¹,

Ronconi²,

Rilli³

et al. 2009

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Primary aldosteronism (PA) due to aldosterone-producing adenoma (APA) is the most common curable form of secondary hypertension. Design: In order to evaluate blood pressure outcome after adrenalectomy for APA and to identify new favorable prognostic factors, data from 42 consecutive APA patients who underwent adrenalectomy were collected from 2005 to 2007. Methods: Renin-angiotensin-aldosterone system (upright and postsaline infusion test), serum and urinary electrolytes, office and ambulatory blood pressure monitoring were evaluated at baseline and after a follow-up of 2.7G2.2 years. Drug history and adenoma size at morphological evaluation were also collected. Results: Multiple regression analysis showed that, before surgery, patients with a small adenoma (diameter !20 mm) displayed higher postsaline aldosterone values (PZ0.0001), and lower serum potassium levels (PZ0.020), than patients with adenoma O20 mm. Before surgery, mineralocorticoid receptor (MR) antagonists were used in patients with small APA in greater percentage than patients with bigger adenomas (64 vs 30% respectively, PZ0.037). At follow-up, blood pressure normalized in 63% of the subjects. Recovered patients had a shorter duration of hypertension (PZ0.038), and a smaller adenoma size (PZ0.035). Receiver operating characteristic curves showed that a duration of hypertension %6 years and an APA size !20 mm were the best predictors of blood pressure normalization. Patients with APA !20 mm showed the complete restoration of blood pressure circadian rhythm. Conclusions: The presence of APA !20 mm, duration of hypertension equal or less than 6 years, and preoperative MR antagonists use are favorable prognostic factors for hypertension recovery after adrenalectomy.

show abstract

“…It is well known that hyperaldosteronism-associated hypokalemia impairs insulin secretion 16,17 and that this defect is only partially reversible after reestablishment of normal plasma K +18 . Induction of hyperaldosteronism in mouse models of diabetes leads to worsening of glucose tolerance, decreased beta-cell mass, and increased oxidative stress markers 19,20 .…”

Section: Aldosterone Mcr and Beta-cell Functionmentioning

confidence: 99%

Aldosterone and the mineralocorticoid receptor in insulin resistance and diabetes

Toloza

Mendivil

2020

ALAD

View full text Add to dashboard Cite

Aldosterone is a key regulator of water and electrolyte metabolism, but recent evidence from multiple lines of research also identifies it as a major player in other chronic disorders, particularly diabetes and the metabolic syndrome. In this review, we summarize relevant aspects of aldosterone production, secretion, action, the way aldosterone and the mineralocorticoid receptor may impact energy metabolism, and useful take-home messages concerning mineralocorticoid antagonism in patients with type 2 diabetes mellitus. (Rev ALAD. 2017;7:203-11) RESUMENLa aldosterona es un regulador clave del metabolismo del agua y los electrólitos, pero la evidencia reciente de múltiples líneas de investigación también la identifica como un actor principal en otros trastornos crónicos, en particular en la diabetes y el síndrome metabólico. En esta revisión se resumen los aspectos relevantes de la producción de aldosterona, así como su secreción, su acción y la forma en que la aldosterona y el receptor mineralocorticoide pueden afectar al metabolismo energético, además de aportar información útil sobre el antagonismo mineralocorticoide en pacientes con diabetes mellitus de tipo 2.Palabras clave: Aldosterona. Metabolismo de los electrólitos. Diabetes. Síndrome Metabólico.

show abstract

The effect of aldosterone on glucose metabolism

Cited by 86 publications

References 24 publications

Insulin Resistance and Hyperinsulinemia Are Related to Plasma Aldosterone Levels in Hypertensive Patients

Insulin Resistance and Hyperinsulinemia Are Related to Plasma Aldosterone Levels in Hypertensive Patients

Small tumor size as favorable prognostic factor after adrenalectomy in Conn's adenoma

Aldosterone and the mineralocorticoid receptor in insulin resistance and diabetes

Contact Info

Product

Resources

About