- 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
-
-
5,143
View
-
131
Download
-
7
Web of Science
-
8
Crossref
-
 Abstract
 PDF PubReader  ePub
- 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
Citations to this article as recorded by  - How should anti-hypertensive medications be adjusted before screening for primary aldosteronism?
Jin-Ying Lu, Yi-Yao Chang, Ting-Wei Lee, Ming-Hsien Wu, Zheng-Wei Chen, Yen-Ta Huang, Tai-Shuan Lai, Leay Kiaw Er, Yen-Hung Lin, Vin-Cent Wu, Hao-Min Cheng, Hsien-Li Kao, Charles Jia-Yin Hou, Kwan-Dun Wu, Szu-Tah Chen, Feng-Hsuan Liu
Journal of the Formosan Medical Association.2024; 123: S91. CrossRef - Diabete e sindrome metabolica nel paziente con iperaldosteronismo primario
Stella Bernardi, Valerio Velardi, Federica De Luca, Giulia Zuolo, Veronica Calabrò, Riccardo Candido, Bruno Fabris
L'Endocrinologo.2024; 25(1): 48. CrossRef - Prevalence, risk factors and evolution of diabetes mellitus after treatment in primary aldosteronism. Results from the SPAIN-ALDO registry
M. Araujo-Castro, M. Paja Fano, B. Pla Peris, M. González Boillos, E. Pascual-Corrales, A. M. García Cano, P. Parra Ramírez, P. Martín Rojas-Marcos, J. G. Ruiz-Sanchez, A. Vicente Delgado, E. Gómez Hoyos, R. Ferreira, I. García Sanz, M. Recasens Sala, R.
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
Endocrine.2022; 79(1): 17. CrossRef - 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
|
KES
