Endocrinology and Metabolism

Vin-Cent Wu (Wu VC)

4 Articles

Clinical Study
Changes in Glucose Metabolism after Adrenalectomy or Treatment with a Mineralocorticoid Receptor Antagonist for Primary Aldosteronism: Yu-Fang Lin, Kang-Yung Peng, Chia-Hui Chang, Ya-Hui Hu, Vin-Cent Wu, Shiu-Dong Chung, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group; Endocrinol Metab. 2020;35(4):838-846. Published online December 2, 2020; DOI: https://doi.org/10.3803/EnM.2020.797

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Background
Data on the effects of excess aldosterone on glucose metabolism are inconsistent. This study compared the changes in glucose metabolism in patients with primary aldosteronism (PA) after adrenalectomy or treatment with a mineralocorticoid receptor antagonist (MRA).
Methods
Overall, 241 patients were enrolled; 153 underwent adrenalectomy and 88 received an MRA. Fasting glucose, homeostatic model assessment of insulin resistance (HOMA-IR), and homeostatic model assessment of β-cell function (HOMA-β) were compared between the treatment groups after 1 year. Plasma aldosterone concentration (PAC) and factors determining HOMA-IR and PAC were evaluated.
Results
No baseline differences were observed between the groups. Fasting insulin, HOMA-IR, and HOMA-β increased in both groups and there were no significant differences in fasting glucose following treatment. Multiple regression analysis showed associations between PAC and HOMA-IR (β=0.172, P=0.017) after treatment. Treatment with spironolactone was the only risk factor associated with PAC >30 ng/dL (odds ratio, 5.2; 95% confidence interval [CI], 2.7 to 10; P<0.001) and conferred a 2.48-fold risk of insulin resistance after 1 year compared with surgery (95% CI, 1.3 to 4.8; P=0.007).
Conclusion
Spironolactone treatment might increase insulin resistance in patients with PA. This strengthened the current recommendation that adrenalectomy is the preferred strategy for patient with positive lateralization test. Achieving a post-treatment PAC of <30 ng/dL for improved insulin sensitivity may be appropriate.

Citations

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Comparative Outcomes of Adrenalectomy, Mineralocorticoid Receptor Antagonist, and Percutaneous Adrenal Ablation for Primary Aldosteronism: A Systematic Review and Network Meta-Analysis
Liyuan Yuan, Xinyi Li, Fang Sun, Yi Tang, Wuhao Wang, Wei Liu, Xiaona Sun, Yushuang Luo, Xiaona Bu, Zongshi Lu, Daoyan Liu, Qiang Li, Zhiming Zhu
American Journal of Hypertension.2025;[Epub] CrossRef
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Journal of the Formosan Medical Association.2024; 123: S91. CrossRef
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L'Endocrinologo.2024; 25(1): 48. CrossRef
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Journal of Endocrinological Investigation.2023; 46(11): 2343. CrossRef
Estimated glomerular filtration rate-dip after medical target therapy associated with increased mortality and cardiovascular events in patients with primary aldosteronism
Jia-Yuh Sheu, Shuo-Meng Wang, Vin-Cent Wu, Kuo-How Huang, Chi-Shin Tseng, Yuan-Ju Lee, Yao-Chou Tsai, Yen-Hung Lin, Jeff S. Chueh
Journal of Hypertension.2023; 41(9): 1401. CrossRef
Risk of dementia in primary aldosteronism compared with essential hypertension: a nationwide cohort study
Namki Hong, Kyoung Jin Kim, Min Heui Yu, Seong Ho Jeong, Seunghyun Lee, Jung Soo Lim, Yumie Rhee
Alzheimer's Research & Therapy.2023;[Epub] CrossRef
Secondary diabetes mellitus due to primary aldosteronism
Melpomeni Moustaki, Stavroula A. Paschou, Eleni C. Vakali, Andromachi Vryonidou
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Serum Cystatin C Levels Could Predict Rapid Kidney Function Decline in A Community-Based Population
Wei-Ching Fang, Hsing-Yu Chen, Shao-Chi Chu, Po-Hsi Wang, Chin-Chan Lee, I-Wen Wu, Chiao-Yin Sun, Heng-Jung Hsu, Chun-Yu Chen, Yung-Chang Chen, Vin-Cent Wu, Heng-Chih Pan
Biomedicines.2022; 10(11): 2789. CrossRef
Recovery from diabetes mellitus in primary aldosteronism patients after adrenalectomy
Yu Liu, Lede Lin, Chi Yuan, Sikui Shen, Yin Tang, Zhihong Liu, Yuchun Zhu, Liang Zhou
BMC Endocrine Disorders.2022;[Epub] CrossRef

Adrenal gland
Primary Aldosteronism and Cerebrovascular Diseases: Zheng-Wei Chen, Chi-Sheng Hung, Vin-Cent Wu, Yen-Hung Lin; Endocrinol Metab. 2018;33(4):429-434. Published online November 30, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.4.429

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Abstract PDF PubReader ePub

As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

Citations

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KCNJ5 Somatic Mutations Are Associated With Better Long-term Outcomes in Patients With Unilateral Primary Aldosteronism
Chieh-Kai Chan, Wei-Shiung Yang, Yen-Hung Lin, Chin-Chen Chang, Vin-Cent Wu, Jeff S Chueh
The Journal of Clinical Endocrinology & Metabolism.2025;[Epub] CrossRef
Association of Dip in eGFR With Clinical Outcomes in Unilateral Primary Aldosteronism Patients After Adrenalectomy
Jui-Yi Chen, Kuo-How Huang, Yen-Hung Lin, Jeff S Chueh, Hsien-Yi Wang, Vin-Cent Wu
The Journal of Clinical Endocrinology & Metabolism.2024; 109(3): e965. CrossRef
Aldosterone and aldosterone synthase inhibitors in cardiorenal disease
Subodh Verma, Avinash Pandey, Arjun K. Pandey, Javed Butler, John S. Lee, Hwee Teoh, C. David Mazer, Mikhail N. Kosiborod, Francesco Cosentino, Stefan D. Anker, Kim A. Connelly, Deepak L. Bhatt
American Journal of Physiology-Heart and Circulatory Physiology.2024; 326(3): H670. CrossRef
Exploring the Spectrum of Comorbidities Associated with Primary Aldosteronism: Insights from a Large Real-World Case-Control Study
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Cardiovascular and metabolic characters of KCNJ5 somatic mutations in primary aldosteronism
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Frontiers in Endocrinology.2023;[Epub] CrossRef
Risk of dementia in primary aldosteronism compared with essential hypertension: a nationwide cohort study
Namki Hong, Kyoung Jin Kim, Min Heui Yu, Seong Ho Jeong, Seunghyun Lee, Jung Soo Lim, Yumie Rhee
Alzheimer's Research & Therapy.2023;[Epub] CrossRef
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Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism
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Cerebro-Cardiovascular Risk, Target Organ Damage, and Treatment Outcomes in Primary Aldosteronism
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Primary Aldosteronism More Prevalent in Patients With Cardioembolic Stroke and Atrial Fibrillation
Van Nguyen, Tian Ming Tu, Marlie Jane B. Mamauag, Jovan Lai, Seyed Ehsan Saffari, Tar Choon Aw, Lizhen Ong, Roger S. Y. Foo, Siang Chew Chai, Shaun Fones, Meifen Zhang, Troy H. Puar
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Implication of MR Activity in Posttreatment Arterial Stiffness Reversal in Patients With Primary Aldosteronism
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Heart-Ankle Pulse Wave Velocity Is Superior to Brachial-Ankle Pulse Wave Velocity in Detecting Aldosterone-Induced Arterial Stiffness
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Effects of nimodipine combined with betahistine on CRP and other inflammatory cytokines and vascular endothelial function in patients with hypertensive cerebral vasospasm
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CTNNB1 Mutation in Aldosterone Producing Adenoma: Jian-Jhong Wang, Kang-Yung Peng, Vin-Cent Wu, Fen-Yu Tseng, Kwan-Dun Wu; Endocrinol Metab. 2017;32(3):332-338. Published online September 18, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.3.332

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Abstract PDF PubReader

Discoveries of somatic mutations permit the recognition of subtypes of aldosterone-producing adenomas (APAs) with distinct clinical presentations and pathological features. Catenin β1 (CTNNB1) mutation in APAs has been recently described and discussed in the literature. However, significant knowledge gaps still remain regarding the prevalence, clinical characteristics, pathophysiology, and outcomes in APA patients harboring CTNNB1 mutations. Aberrant activation of the Wnt/β-catenin signaling pathway will further modulate tumorigenesis. We also discuss the recent knowledge of CTNNB1 mutation in adrenal adenomas.

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Molecular and Genetics Perspectives on Primary Adrenocortical Hyperfunction Disorders
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Liquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism: Bo-Ching Lee, Chien-Wei Huang, Chin-Chen Chang, Guan-Yuan Chen, Jia-Zheng Huang, Pin-Chen Chen, Te-I Weng, Kao-Lang Liu, Vin-Cent Wu, Yen-Hung Lin, on Behalf of the TAIPAI Study Group; Received November 6, 2024 Accepted April 23, 2025 Published online July 1, 2025; DOI: https://doi.org/10.3803/EnM.2024.2237 [Epub ahead of print]

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Abstract PDF: Background
Adrenal venous sampling (AVS) is essential for diagnosing unilateral aldosterone oversecretion in primary aldosteronism (PA). Traditionally, AVS relies on radioimmunoassay (RIA) to measure plasma aldosterone concentration (PAC), although RIA has limited specificity and considerable variability. This study evaluated the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS) in AVS and its impact on clinical outcomes.
Methods
Among 230 patients with PA (May 2020 to April 2023) who underwent AVS, successful sampling was achieved in 182 patients (79.1%) under unstimulated conditions and 206 patients (89.6%) under stimulated conditions. PAC levels from peripheral and adrenal veins measured by LC-MS/MS were compared with RIA results. Patient outcomes were categorized according to the Primary Aldosteronism Surgical Outcomes criteria.
Results
LC-MS/MS showed significant correlations with PAC levels measured by RIA in AVS (r=0.40 [unstimulated] and r=0.56 [stimulated]; both P<0.001). However, lateralization concordance between RIA and LC-MS/MS was moderate, at only 57.7% (unstimulated) and 64.6% (stimulated). LC-MS/MS identified more unilateral disease than RIA under both unstimulated (61.5% vs. 37.4%, P<0.001) and stimulated conditions (36.4% vs. 9.7%, P<0.001). Patients achieving complete clinical success after adrenalectomy were more accurately identified by LC-MS/MS than RIA under stimulated (55.6% vs. 22.2%, P=0.035), but not in unstimulated conditions.
Conclusion
LC-MS/MS outperformed RIA in identifying unilateral disease, resulting in higher rates of complete clinical success in adrenalectomy patients when surgical decisions were based on LC-MS/MS lateralization results.

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