Endocrinology and Metabolism

Special Article

Adrenal gland
2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism: Jeonghoon Ha, Jung Hwan Park, Kyoung Jin Kim, Jung Hee Kim, Kyong Yeun Jung, Jeongmin Lee, Jong Han Choi, Seung Hun Lee, Namki Hong, Jung Soo Lim, Byung Kwan Park, Jung-Han Kim, Kyeong Cheon Jung, Jooyoung Cho, Mi-kyung Kim, Choon Hee Chung, The Committee of Clinical Practice Guideline of Korean Endocrine Society, The Korean Adrenal Study Group of Korean Endocrine Society; Endocrinol Metab. 2023;38(6):597-618. Published online October 13, 2023; DOI: https://doi.org/10.3803/EnM.2023.1789

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Primary aldosteronism (PA) is a common, yet underdiagnosed cause of secondary hypertension. It is characterized by an overproduction of aldosterone, leading to hypertension and/or hypokalemia. Despite affecting between 5.9% and 34% of patients with hypertension, PA is frequently missed due to a lack of clinical awareness and systematic screening, which can result in significant cardiovascular complications. To address this, medical societies have developed clinical practice guidelines to improve the management of hypertension and PA. The Korean Endocrine Society, drawing on a wealth of research, has formulated new guidelines for PA. A task force has been established to prepare PA guidelines, which encompass epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, and follow-up care. The Korean clinical guidelines for PA aim to deliver an evidence-based protocol for PA diagnosis, treatment, and patient monitoring. These guidelines are anticipated to ease the burden of this potentially curable condition.

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Correlation of Histopathologic Subtypes of Primary Aldosteronism with Clinical Phenotypes and Postsurgical Outcomes
Chang Ho Ahn, You-Bin Lee, Jae Hyeon Kim, Young Lyun Oh, Jung Hee Kim, Kyeong Cheon Jung
The Journal of Clinical Endocrinology & Metabolism.2023;[Epub] CrossRef

Original Articles

Diabetes, Obesity and Metabolism
Tetrahydrocurcumin Ameliorates Kidney Injury and High Systolic Blood Pressure in High-Fat Diet-Induced Type 2 Diabetic Mice: Weerapon Sangartit, Kyung Bong Ha, Eun Soo Lee, Hong Min Kim, Upa Kukongviriyapan, Eun Young Lee, Choon Hee Chung; Endocrinol Metab. 2021;36(4):810-822. Published online August 27, 2021; DOI: https://doi.org/10.3803/EnM.2021.988

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Background
Activation of the intrarenal renin-angiotensin system (RAS) is implicated in the pathogenesis of kidney injury and hypertension. We aimed to investigate the protective effect of tetrahydrocurcumin (THU) on intrarenal RAS expression, kidney injury, and systolic blood pressure (SBP) in high-fat diet (HFD)-induced type 2 diabetic mice.
Methods
Eight-week-old male mice were fed a regular diet (RD) or HFD for 12 weeks, and THU (50 or 100 mg/kg/day) was intragastrically administered with HFD. Physiological and metabolic changes were monitored and the expression of RAS components and markers of kidney injury were assessed.
Results
HFD-fed mice exhibited hyperglycemia, insulin resistance, and dyslipidemia compared to those in the RD group (P<0.05). Kidney injury in these mice was indicated by an increase in the ratio of albumin to creatinine, glomerular hypertrophy, and the effacement of podocyte foot processes. Expression of intrarenal angiotensin-converting enzyme, angiotensin II type I receptor, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-4, and monocyte chemoattractant protein-1 was also markedly increased in HFD-fed mice. HFD-fed mice exhibited elevated SBP that was accompanied by an increase in the wall thickness and vascular cross-sectional area (P<0.05), 12 weeks post-HFD consumption. Treatment with THU (100 mg/kg/day) suppressed intrarenal RAS activation, improved insulin sensitivity, and reduced SBP, thus, attenuating kidney injury in these mice.
Conclusion
THU alleviated kidney injury in mice with HFD-induced type 2 diabetes, possibly by blunting the activation of the intrarenal RAS/nicotinamide adenine dinucleotide phosphate oxidase IV (NOX4)/monocyte chemoattractant protein 1 (MCP-1) axis and by lowering the high SBP.

Citations

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The Development of Dyslipidemia in Chronic Kidney Disease and Associated Cardiovascular Damage, and the Protective Effects of Curcuminoids
Zeltzin Alejandra Ceja-Galicia, Ana Karina Aranda-Rivera, Isabel Amador-Martínez, Omar Emiliano Aparicio-Trejo, Edilia Tapia, Joyce Trujillo, Victoria Ramírez, José Pedraza-Chaverri
Foods.2023; 12(5): 921. CrossRef
Translation Animal Models of Diabetic Kidney Disease: Biochemical and Histological Phenotypes, Advantages and Limitations
Wenting Luo, Shiyun Tang, Xiang Xiao, Simin Luo, Zixuan Yang, Wei Huang, Songqi Tang
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 1297. CrossRef
Curcumin ameliorates focal segmental glomerulosclerosis by inhibiting apoptosis and oxidative stress in podocytes
Hui Zhang, Qing-Qing Dong, Hua-Pan Shu, Yu-Chi Tu, Qian-Qian Liao, Li-Jun Yao
Archives of Biochemistry and Biophysics.2023; 746: 109728. CrossRef
An examination of the protective effects and molecular mechanisms of curcumin, a polyphenol curcuminoid in diabetic nephropathy
Xiaoyu Zhu, Xingli Xu, Chigang Du, Yanping Su, Lixue Yin, Xiaoqiu Tan, Hui Liu, Yiru Wang, Lei Xu, Xinghua Xu
Biomedicine & Pharmacotherapy.2022; 153: 113438. CrossRef
An integrated bioinformatics analysis and experimental study identified key biomarkers CD300A or CXCL1, pathways and immune infiltration in diabetic nephropathy mice
WEI LIANG, QIANG LUO, ZONGWEI ZHANG, KEJU YANG, ANKANG YANG, QINGJIA CHI, HUAN HU
BIOCELL.2022; 46(8): 1989. CrossRef

Adrenal Gland
Contralateral Suppression at Adrenal Venous Sampling Is Associated with Renal Impairment Following Adrenalectomy for Unilateral Primary Aldosteronism: Ye Seul Yang, Seung Hun Lee, Jung Hee Kim, Jee Hee Yoo, Jung Hyun Lee, Seo Young Lee, A Ram Hong, Dong-Hwa Lee, Jung-Min Koh, Jae Hyeon Kim, Sang Wan Kim; Endocrinol Metab. 2021;36(4):875-884. Published online August 11, 2021; DOI: https://doi.org/10.3803/EnM.2021.1047

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Background
Adrenal venous sampling (AVS) is performed to distinguish the subtype of primary aldosteronism (PA). The clinical implication of contralateral suppression (CS; aldosterone/cortisol_nondominantperipheral) at AVS remains unclear. We aimed to investigate the clinical significance of CS and its impact on postoperative outcomes after unilateral adrenalectomy.
Methods
In this retrospective observational multi-center study, we analyzed PA patients who underwent both successful adrenocorticotropin hormone-stimulated AVS and unilateral adrenalectomy. Successful cannulation was defined as the selectivity index (cortisol_adrenal/ cortisol_peripheral) ≥3. Clinical and biochemical outcomes after unilateral adrenalectomy were evaluated based on the international Primary Aldosteronism Surgical Outcome consensus.
Results
Among 263 patients analyzed, 247 had CS (93.9%). Patients with CS had lower serum potassium levels, higher plasma aldosterone concentration, higher aldosterone-to-renin ratio (ARR), and larger adenoma size than those without CS. Those with CS showed significantly higher lateralization index than those without CS (P<0.001). Although postoperative blood pressure and ARR significantly decreased in those with CS, clinical and biochemical outcomes were comparable in both groups. When the cut-off value of age was determined using receiver operating characteristic (ROC) analysis, patients aged ≥50 years old with contralateral suppression index (CSI; the ratio between aldosterone/cortisol_nondominant and aldosterone/cortisol_peripheral) ≤0.26 had greater odds ratio (6.43; 95% confidence interval, 1.30 to 31.69) of incident chronic kidney disease than those aged <50 years with CSI >0.26 after adjusting for other factors.
Conclusion
CS may not predict postoperative clinical and biochemical outcomes in subjects with unilateral aldosterone excess, but it is associated with postsurgical deterioration of renal function in subjects over 50 years with CSI ≤0.26.

Citations

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Treatment decision based on unilateral index from nonadrenocorticotropic hormone-stimulated and adrenocorticotropic hormone-stimulated adrenal vein sampling in primary aldosteronism
Xizi Zhang, Xiaoyu Shu, Feifei Wu, Jun Yang, Qingfeng Cheng, Zhipeng Du, Ying Song, Yi Yang, Jinbo Hu, Yue Wang, Qifu Li, Shumin Yang
Journal of Hypertension.2024; 42(3): 450. CrossRef
Prognostic value of contralateral suppression on kidney function after surgery in patients with primary aldosteronism
Nathalie Voss, Sara Mørup, Caroline Clausen, Claus larsen Feltoft, Jan Viberg Jepsen, Mads Hornum, Mikkel Andreassen, Jesper Krogh
Clinical Endocrinology.2023; 98(3): 306. CrossRef
Factors Predicting Long-term Estimated Glomerular Filtration Rate Decrease, a Reliable Indicator of Renal Function After Adrenalectomy in Primary Aldosteronism
Qiyu He, Zhimin Tan, Yu Liu, Liang Zhou
Endocrine Practice.2023; 29(3): 199. CrossRef
Correlation of Histopathologic Subtypes of Primary Aldosteronism with Clinical Phenotypes and Postsurgical Outcomes
Chang Ho Ahn, You-Bin Lee, Jae Hyeon Kim, Young Lyun Oh, Jung Hee Kim, Kyeong Cheon Jung
The Journal of Clinical Endocrinology & Metabolism.2023;[Epub] CrossRef
Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism
Sara Mørup, Nathalie Voss, Caroline Clausen, Claus Larsen Feltoft, Mikkel Andreassen, Jesper Krogh
Clinical Endocrinology.2022; 96(6): 793. CrossRef
Contralateral Suppression at Adrenal Venous Sampling Is Associated with Renal Impairment Following Adrenalectomy for Unilateral Primary Aldosteronism (Endocrinol Metab 2021;36:875-84, Ye Seul Yang et al.)
Zhimin Tan, Qiyu He, Liang Zhou
Endocrinology and Metabolism.2022; 37(6): 951. CrossRef
Contralateral Suppression at Adrenal Venous Sampling Is Associated with Renal Impairment Following Adrenalectomy for Unilateral Primary Aldosteronism (Endocrinol Metab 2021;36:875-84, Ye Seul Yang et al.)
Ye Seul Yang, Sang Wan Kim
Endocrinology and Metabolism.2022; 37(6): 953. CrossRef

Thyroid
The Positive Association between Subclinical Hypothyroidism and Newly-Diagnosed Hypertension Is More Explicit in Female Individuals Younger than 65: Xichang Wang, Haoyu Wang, Li Yan, Lihui Yang, Yuanming Xue, Jing Yang, Yongli Yao, Xulei Tang, Nanwei Tong, Guixia Wang, Jinan Zhang, Youmin Wang, Jianming Ba, Bing Chen, Jianling Du, Lanjie He, Xiaoyang Lai, Yanbo Li, Zhaoli Yan, Eryuan Liao, Chao Liu, Libin Liu, Guijun Qin, Yingfen Qin, Huibiao Quan, Bingyin Shi, Hui Sun, Zhen Ye, Qiao Zhang, Lihui Zhang, Jun Zhu, Mei Zhu, Yongze Li, Weiping Teng, Zhongyan Shan; Endocrinol Metab. 2021;36(4):778-789. Published online August 10, 2021; DOI: https://doi.org/10.3803/EnM.2021.1101

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Background
Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension.
Methods
Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017.
Results
The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years.
Conclusion
The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

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Systematic review and meta-analysis of levothyroxine effect on blood pressure in patients with subclinical hypothyroidism
Bahar Darouei, Reza Amani-Beni, Amir Parsa Abhari, Mohammad Fakhrolmobasheri, Davood Shafie, Maryam Heidarpour
Current Problems in Cardiology.2024; 49(2): 102204. CrossRef
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Fan Zhang, Di Teng, Nanwei Tong, Guixia Wang, Yongze Li, Xiaohui Yu, Zhongyan Shan, Weiping Teng
Thyroid.2022; 32(5): 571. CrossRef
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The Journal of Clinical Endocrinology & Metabolism.2022; 107(9): 2674. CrossRef

Review Article

Obesity and Metabolism
An Update on Contraception in Polycystic Ovary Syndrome: Seda Hanife Oguz, Bulent Okan Yildiz; Endocrinol Metab. 2021;36(2):296-311. Published online April 15, 2021; DOI: https://doi.org/10.3803/EnM.2021.958

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Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, characterized by hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology. Combined oral contraceptives (COCs), along with lifestyle modifications, represent the first-line medical treatment for the long-term management of PCOS. Containing low doses of estrogen and different types of progestin, COCs restore menstrual cyclicity, improve hyperandrogenism, and provide additional benefits such as reducing the risk of endometrial cancer. However, potential cardiometabolic risk associated with these agents has been a concern. COCs increase the risk of venous thromboembolism (VTE), related both to the dose of estrogen and the type of progestin involved. Arterial thrombotic events related to COC use occur much less frequently, and usually not a concern for young patients. All patients diagnosed with PCOS should be carefully evaluated for cardiometabolic risk factors at baseline, before initiating a COC. Age, smoking, obesity, glucose intolerance or diabetes, hypertension, dyslipidemia, thrombophilia, and family history of VTE should be recorded. Patients should be re-assessed at consecutive visits, more closely if any baseline cardiometabolic risk factor is present. Individual risk assessment is the key in order to avoid unfavorable outcomes related to COC use in women with PCOS.

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Elena Rosato, Francesca Sciarra, Marianna Minnetti, Anisa Degjoni, Mary Anna Venneri
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Il rischio tromboembolico nella sindrome dell’ovaio policistico
Davide Ceccato, Francesca Dassie, Pietro Maffei, Roberto Mioni
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Systematic exploration of network pharmacology, in silico modeling and pharmacokinetic profiling for vitamin E in polycystic ovarian syndrome
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Future Science OA.2024;[Epub] CrossRef
Current and emerging drug treatment strategies for polycystic ovary syndrome
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Expert Opinion on Pharmacotherapy.2023; 24(1): 105. CrossRef
Weighted Gene Co-Expression Network Analysis (WGCNA) Discovered Novel Long Non-Coding RNAs for Polycystic Ovary Syndrome
Roozbeh Heidarzadehpilehrood, Maryam Pirhoushiaran, Malina Binti Osman, Habibah Abdul Hamid, King-Hwa Ling
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Mali Wu, Hua Liu, Jie Zhang, Fangfang Dai, Yiping Gong, Yanxiang Cheng
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Evaluation of the efficacy of an antioxidant combination for the modulation of metabolic, endocrine, and clinical parameters in patients with polycystic ovary syndrome
Carmen Pingarrón Santofímia, Silvia Poyo Torcal, Helena López Verdú, Alexandra Henríquez Linares, Virginia Calvente Aguilar, Pablo Terol Sánchez, María Sol Martínez García, Pilar Lafuente González
Gynecological Endocrinology.2023;[Epub] CrossRef
Contemporary Management of the Patient with Polycystic Ovary Syndrome
Nicolás Omar Francone, Tia Ramirez, Christina E. Boots
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Beate C. Sydora, Michaelann S. Wilke, Maggie McPherson, Sarah Chambers, Mahua Ghosh, Donna F. Vine
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Mona Tamaddon, Mostafa Azimzadeh, Seyed Mohammad Tavangar
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Original Article

Clinical Study
Apolipoprotein B Levels Predict Future Development of Hypertension Independent of Visceral Adiposity and Insulin Sensitivity: Seung Jin Han, Wilfred Y. Fujimoto, Steven E. Kahn, Donna L. Leonetti, Edward J. Boyko; Endocrinol Metab. 2020;35(2):351-358. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.351

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Background
High plasma apolipoprotein B (apoB) levels have been shown to be associated with hypertension, central obesity, and insulin resistance in cross-sectional research. However, it is unclear whether apoB levels predict future hypertension independent of body composition and insulin sensitivity. Therefore, we prospectively investigated whether plasma apoB concentrations independently predicted the risk of hypertension in a cohort of Japanese Americans.
Methods
A total of 233 normotensive Japanese Americans (77 men, 156 women; mean age, 46.4±11.0 years) were followed over 10 years to monitor them for the development of hypertension. Fasting plasma concentrations of apoB, glucose, and insulin were measured at baseline. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). The abdominal visceral and subcutaneous fat areas were measured at baseline using computed tomography. Logistic regression analysis was used to estimate the association between apoB concentrations and the odds of incident hypertension.
Results
The 10-year cumulative incidence of hypertension was 21.5%. The baseline apoB level was found to be positively associated with the odds of incident hypertension over 10 years after adjustment for age, sex, body mass index, systolic blood pressure, abdominal visceral fat area, abdominal subcutaneous fat area, total plasma cholesterol concentration, diabetes status, and HOMA-IR at baseline (odds ratio and 95% confidence interval for a 1-standard deviation increase, 1.89 [1.06 to 3.37]; P=0.030).
Conclusion
Higher apoB concentrations predicted greater risks of future hypertension independent of abdominal visceral fat area and insulin sensitivity in Japanese Americans.

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Review Articles

Diabetes
Prevalence and Current Management of Cardiovascular Risk Factors in Korean Adults Based on Fact Sheets: Eun-Jung Rhee; Endocrinol Metab. 2020;35(1):85-94. Published online March 19, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.1.85

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Korea is currently an aged society and is on the cusp of becoming a superaged society in a few years. The health burden of cardiovascular diseases increases with age, and the increasing prevalence of cardiovascular risk factors, such as obesity, hypertension, diabetes mellitus, and dyslipidemia, may be linked to increased population-level cardiovascular risk. In 2018, the prevalence of obesity in Korea was 35.7% (men, 45.4%; women, 26.5%) according to the Obesity Fact Sheet 2019, based on National Health Insurance Corporation medical checkup data. In 2016, the prevalence of diabetes was 14.4% in Koreans older than 30 years according to the Diabetes Fact Sheet published by the Korean Diabetes Association, based on data from the Korean National Health and Nutrition Examination Survey. The prevalence of hypertension in the total population of Korea in 2018 was 28.3% according to the Korean Hypertension Fact Sheet produced by the Korean Society of Hypertension. Lastly, the prevalence of dyslipidemia in 2018 was 40.5% according to the Dyslipidemia Fact Sheet published by the Korean Society of Lipid and Atherosclerosis. In this article, I would like to review the prevalence and current management of cardiovascular risk factors in Korea according to the fact sheets released by various associations.

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Adrenal gland
Molecular Mechanisms of Primary Aldosteronism: Sergei G. Tevosian, Shawna C. Fox, Hans K. Ghayee; Endocrinol Metab. 2019;34(4):355-366. Published online December 23, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.4.355

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Primary aldosteronism (PA) results from excess production of mineralocorticoid hormone aldosterone by the adrenal cortex. It is normally caused either by unilateral aldosterone-producing adenoma (APA) or by bilateral aldosterone excess as a result of bilateral adrenal hyperplasia. PA is the most common cause of secondary hypertension and associated morbidity and mortality. While most cases of PA are sporadic, an important insight into this debilitating disease has been derived through investigating the familial forms of the disease that affect only a minor fraction of PA patients. The advent of gene expression profiling has shed light on the genes and intracellular signaling pathways that may play a role in the pathogenesis of these tumors. The genetic basis for several forms of familial PA has been uncovered in recent years although the list is likely to expand. Recently, the work from several laboratories provided evidence for the involvement of mammalian target of rapamycin pathway and inflammatory cytokines in APAs; however, their mechanism of action in tumor development and pathophysiology remains to be understood.

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Mineralocorticoid Receptor and Aldosterone: Interaction Between NR3C2 Genetic Variants, Sex, and Age in a Mixed Cohort
Mahyar Heydarpour, Wasita W Parksook, Luminita H Pojoga, Gordon H Williams, Jonathan S Williams
The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef
Proteomic analysis of urinary extracellular vesicles highlights specific signatures for patients with primary aldosteronism
Lorenzo Bertolone, Annalisa Castagna, Marcello Manfredi, Domenica De Santis, Francesca Ambrosani, Elisa Antinori, Paolo Mulatero, Elisa Danese, Emilio Marengo, Elettra Barberis, Mariangela Veneri, Nicola Martinelli, Simonetta Friso, Francesca Pizzolo, Oli
Frontiers in Endocrinology.2023;[Epub] CrossRef
Focus on adrenal and related causes of hypertension in childhood and adolescence: Rare or rarely recognized?
Flávia A. Costa-Barbosa, Rafael B. Giorgi, Claudio E. Kater
Archives of Endocrinology and Metabolism.2022;[Epub] CrossRef
Diseases caused by mutations in the Na+/K+ pump α1 gene ATP1A1
Elisa D. Biondo, Kerri Spontarelli, Giovanna Ababioh, Lois Méndez, Pablo Artigas
American Journal of Physiology-Cell Physiology.2021; 321(2): C394. CrossRef
Aldosterone Inhibits In Vitro Myogenesis by Increasing Intracellular Oxidative Stress via Mineralocorticoid Receptor
Jin Young Lee, Da Ae Kim, Eunah Choi, Yun Sun Lee, So Jeong Park, Beom-Jun Kim
Endocrinology and Metabolism.2021; 36(4): 865. CrossRef
Progress on Genetic Basis of Primary Aldosteronism
Izabela Karwacka, Łukasz Obołończyk, Sonia Kaniuka-Jakubowska, Michał Bohdan, Krzysztof Sworczak
Biomedicines.2021; 9(11): 1708. CrossRef

Original Articles

Adrenal gland
C-Arm Computed Tomography-Assisted Adrenal Venous Sampling Improved Right Adrenal Vein Cannulation and Sampling Quality in Primary Aldosteronism: Chung Hyun Park, Namki Hong, Kichang Han, Sang-Wook Kang, Cho Rok Lee, Sungha Park, Yumie Rhee; Endocrinol Metab. 2018;33(2):236-244. Published online May 4, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.2.236

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Background

Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling.

Methods

A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included. Based on the medical records, we retrospectively compared the overall, left, and right catheterization success rates of adrenal veins during the periods without C-AVS (2004 to 2010, n=32) and with C-AVS (2011 to 2016, n=124). The primary outcome was adequate bilateral sampling defined as a selectivity index (SI) >5.

Results

With C-AVS, the rates of adequate bilateral AVS increased from 40.6% to 88.7% (P<0.001), with substantial decreases in failure rates (43.7% to 0.8%, P<0.001). There were significant increases in adequate sampling rates from right (43.7% to 91.9%, P<0.001) and left adrenal veins (53.1% to 95.9%, P<0.001) as well as decreases in catheterization failure from right adrenal vein (9.3% to 0.0%, P<0.001). Net improvement of SI on right side remained significant after adjustment for left side (adjusted SI, 1.1 to 9.0; P=0.038). C-AVS was an independent predictor of adequate bilateral sampling in the multivariate model (odds ratio, 9.01; P<0.001).

Conclusion

C-AVS improved the overall success rate of AVS, possibly as a result of better catheterization of right adrenal vein.

Citations

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Utility of right adrenal signature veins in venous sampling for primary aldosteronism
Zhenglin Shen, Shaoyong Xu, Siyu Guan, Bo Chen, Qingan Li, Ming Yu, Zhao Gao
Annals of Medicine.2023;[Epub] CrossRef
Key to the Treatment of Primary Aldosteronism in Secondary Hypertension: Subtype Diagnosis
Rui Zuo, Shuang Liu, Lu Xu, Hua Pang
Current Hypertension Reports.2023; 25(12): 471. CrossRef
A clinical assessment of portable point-of-care testing for quick cortisol assay during adrenal vein sampling
Ko Aiga, Mitsuhiro Kometani, Shigehiro Karashima, Seigo Konishi, Takuya Higashitani, Daisuke Aono, Xurong Mai, Mikiya Usukura, Takahiro Asano, Ayako Wakayama, Yuko Noda, Wataru Koda, Tetsuya Minami, Satoshi Kobayashi, Toshinori Murayama, Takashi Yoneda
Scientific Reports.2023;[Epub] CrossRef
Does Intraprocedural CT Improve the Success Rate of Adrenal Venous Sampling? A Systematic Review and Meta-Analysis of Data from 809 Patients
Nima Hafezi-Nejad, David M. Gullotti, Christopher R. Bailey, Mark L. Lessne, Brian P. Holly
CardioVascular and Interventional Radiology.2022; 45(1): 29. CrossRef
Prevalence and clinical characteristics of primary aldosteronism in a tertiary-care center in Korea
Minjae Yoon, Namki Hong, Jaehyung Ha, Chan Joo Lee, Cheol Ryong Ku, Yumie Rhee, Sungha Park
Hypertension Research.2022; 45(9): 1418. CrossRef
Cone-beam computed tomography is not a mandatory procedure in adrenal venous sampling for primary hyperaldosteronism
Ran Cai, Chao Hu, Hai-Yang Li
BMC Medical Imaging.2022;[Epub] CrossRef
Adrenal Venous Sampling for Subtype Diagnosis of Primary Hyperaldosteronism
Mitsuhide Naruse, Akiyo Tanabe, Koichi Yamamoto, Hiromi Rakugi, Mitsuhiro Kometani, Takashi Yoneda, Hiroki Kobayashi, Masanori Abe, Youichi Ohno, Nobuya Inagaki, Shoichiro Izawa, Masakatsu Sone
Endocrinology and Metabolism.2021; 36(5): 965. CrossRef
Controversies and advances in adrenal venous sampling in the diagnostic workup of primary aldosteronism
Martin Wolley, Moe Thuzar, Michael Stowasser
Best Practice & Research Clinical Endocrinology & Metabolism.2020; 34(3): 101400. CrossRef
Update on the Aldosterone Resolution Score and Lateralization in Patients with Primary Aldosteronism
Eun-Hee Cho
Endocrinology and Metabolism.2018; 33(3): 352. CrossRef

Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension: Mohsen Janghorbani, Mohammad Reza Salamat, Ashraf Aminorroaya, Masoud Amini; Endocrinol Metab. 2017;32(2):221-229. Published online May 19, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.221

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Background

The aim of this study was to assess the utility of the visceral adiposity index (VAI) and the hypertriglyceridemic waist (HTGW) phenotype as possible hypertension (HTN) predictors in a high-risk population without diabetes and HTN.

Methods

Incident HTN over a 7-year follow-up was assessed among 1,375 first-degree non-diabetic and non-hypertensive relatives of consecutive patients with type 2 diabetes who were 30 to 70 years of age. HTN was defined as a blood pressure reading ≥140/90 mm Hg or the use of antihypertensive medications. We examined the incidence of HTN across VAI quintiles and four groups defined according to baseline fasting serum triglyceride (TG) levels and waist circumference (WC).

Results

The VAI and the HTGW phenotype at baseline were related to an increased risk for HTN. In comparison with the lowest VAI quintile, the highest VAI quintile showed a significant associated with HTN in an age- and gender-adjusted model (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.07 to 2.55). Those with HTGW were 2.3 times (OR, 2.27; 95% CI, 1.54 to 3.35) more likely to develop HTN than those with a normal WC and normal TG levels.

Conclusion

Greater VAI values weakly predicted HTN, whereas the HTGW phenotype was a stronger predictor of incident HTN in an Iranian high-risk population.

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Yifan Fan, Zhe Wang, Xiaotao Zhao, Shouling Wu, Hongjie Chi
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Omar M. Mahmoud, Gehad Abd Elaziz Mahmoud, Haisam Atta, Wael A. Abbas, Hanan M. Ahmed, Mohamed A. A. Abozaid
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Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1885. CrossRef
Chinese Visceral Adiposity Index Is More Closely Associated With Hypertension and Prehypertension Than Traditional Adiposity Indices in Chinese Population: Results From the REACTION Study
Binqi Li, Jie Wang, Xin Zhou, Yang Liu, Weiqing Wang, Zhengnan Gao, Xulei Tang, Li Yan, Qin Wan, Zuojie Luo, Guijun Qin, Lulu Chen, Guang Ning, Yiming Mu
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Yifan Fan, Yulin Guo, Jiuchang Zhong, Hongjie Chi, Xiaotao Zhao, Pixiong Su, Jie Gao, Mulei Chen
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Nathália Nogueira Leite, Bruna Clemente Cota, Ana Raquel Ernesto Manuel Gotine, Daniela Mayumi Usuda Prado Rocha, Patrícia Feliciano Pereira, Helen Hermana Miranda Hermsdorff
Obesity Research & Clinical Practice.2021; 15(6): 546. CrossRef
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Begoña de Cuevillas, Ismael Alvarez-Alvarez, Jose I. Riezu-Boj, Santiago Navas-Carretero, J. Alfredo Martinez
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Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study
Meizhen Gu, Weijun Huang, Xinyi Li, Yupu Liu, Fan Wang, Chao Fang, Ting Chen
Nature and Science of Sleep.2021; Volume 13: 2165. CrossRef
The Visceral Adipose Index in Relation to Incidence of Hypertension in Chinese Adults: China Health and Nutrition Survey (CHNS)
Yong Xue, Qun Shen, Chang Li, Zijian Dai, Tingchao He
Nutrients.2020; 12(3): 805. CrossRef
Visceral-to-Subcutaneous Abdominal Fat Ratio Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis
Chan-Hee Jung, Eun-Jung Rhee, Hyemi Kwon, Yoosoo Chang, Seungho Ryu, Won-Young Lee
Endocrinology and Metabolism.2020; 35(1): 165. CrossRef
Severity of the metabolic syndrome as a predictor of prediabetes and type 2 diabetes in first degree relatives of type 2 diabetic patients: A 15-year prospective cohort study
Rokhsareh Meamar, Masoud Amini, Ashraf Aminorroaya, Maryam Nasri, Majid Abyar, Awat Feizi
World Journal of Diabetes.2020; 11(5): 202. CrossRef
Association between Visceral Adiposity Index and hypertension among Chinese Adults: a nationwide cross-sectional study in the China Health and Nutrition Survey
Jing Yang, Hongxia Li, Lianhua Han, Lei Zhang, Yafeng Zhou
Blood Pressure Monitoring.2020; 25(5): 271. CrossRef
Hypertriglyceridemic Waist Phenotype and Lipid Accumulation Product: Two Comprehensive Obese Indicators of Waist Circumference and Triglyceride to Predict Type 2 Diabetes Mellitus in Chinese Population
Minrui Xu, Mingtao Huang, Deren Qiang, Jianxin Gu, Yong Li, Yingzi Pan, Xingjuan Yao, Wenchao Xu, Yuan Tao, Yihong Zhou, Hongxia Ma, Ulrike Rothe
Journal of Diabetes Research.2020; 2020: 1. CrossRef
Association of the hypertriglyceridemic waist phenotype and severity of acute pancreatitis
Yanbing Ding, Min Zhang, Lisheng Wang, Tao Yin, Ningzhi Wang, Jian Wu, Jiehua Zhi, Weiwei Chen, Keyan Wu, Weijuan Gong, Weiming Xiao, Zhenglei Xu, Guotao Lu
Lipids in Health and Disease.2019;[Epub] CrossRef
Association between the Hypertriglyceridemic Waist Phenotype and Prediabetes in Chinese Adults Aged 40 Years and Older
Kun Zhao, Shan-Shan Yang, Hai-Bin Wang, Kang Chen, Zhao-Hui Lu, Yi-Ming Mu
Journal of Diabetes Research.2018; 2018: 1. CrossRef
Sex-specific relationship between visceral fat index and dyslipidemia in Chinese rural adults: The Henan Rural Cohort Study
Zhongyan Tian, Yuqian Li, Zhenxing Mao, Songcheng Yu, Yanhua Wang, Xiaotian Liu, Runqi Tu, Haiqing Zhang, Xinling Qian, Xia Zhang, Lulu Zhang, Jingzhi Zhao, Lei Yin, Chongjian Wang
Preventive Medicine.2018; 116: 104. CrossRef
Response: Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension (Endocrinol Metab 2017;32:221-9, Mohsen Janghorbani et al.)
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Endocrinology and Metabolism.2017; 32(4): 485. CrossRef
Letter: Utility of the Visceral Adiposity Index and Hypertriglyceridemic Waist Phenotype for Predicting Incident Hypertension (Endocrinol Metab 2017;32:221-9, Mohsen Janghorbani et al.)
Eun-Jung Rhee
Endocrinology and Metabolism.2017; 32(3): 396. CrossRef

Obesity and Metabolism
The Impact of Different Anthropometric Measures on Sustained Normotension, White Coat Hypertension, Masked Hypertension, and Sustained Hypertension in Patients with Type 2 Diabetes: Baris Afsar; Endocrinol Metab. 2013;28(3):199-206. Published online September 13, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.3.199

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Background

Many studies have aimed to determine whether body mass index (BMI), waist circumference (WC), or waist to hip ratio (WHR) best predicts hypertension in diabetic patients, with conflicting results. However, no study has examined the specific relationship between these anthropometric parameters with sustained normotension (SNT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT) based on office and ambulatory blood pressure (BP) measurements in these patients.

Methods

Patients with newly diagnosed type 2 diabetes underwent the following procedures: history taking, measurements of anthropometric parameters, office and ambulatory BP measurements, physical examination, laboratory analysis, and random and 24-hour urine analysis.

Results

In total, there were 65 dippers and 37 nondipper patients. None of the anthropometric parameters were different between the dippers and the nondippers. There were 25 patients with SNT, 32 with WCHT, seven with MHT, and 38 with SHT. A comparison of anthropometric parameters between these four groups of patients showed that WC (P=0.016) and WHR (P=0.015) were different among all groups. According to regression analysis, only BMI was independently related with MHT (odds ratio [OR], 1.373, P=0.022), whereas only WC has been associated with SHT (OR, 1.321, P=0.041).

Conclusion

Among anthropometric parameters, only WC and WHR were different in SNT, WCHT, MHT, and SHT in newly diagnosed patients with type 2 diabetes.

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Case Report

A Case of Ascites and Extensive Abdominal Distension Caused by Reversible Pulmonary Arterial Hypertension Associated with Graves' Disease.: Byoungho Choi, Young Sil Eom, Sei Hyun Kim, Hyun Seok Choi, Wook Jin Chung, Sihoon Lee; Endocrinol Metab. 2011;26(3):248-252. Published online September 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.3.248

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Patients with hyperthyroidism can develop left ventricular dysfunction and heart failure, but severe pulmonary hypertension association with hyperthyroidism is rarely seen. Herein, we describe the case of a 27-year-old female who presented with abdominal distension accompanied by pulmonary arterial hypertension and Graves' disease. Her pulmonary arterial hypertension was improved by treating the hyperthyroidism and pulmonary artery hypertension. Additionally, the patient's symptoms of right-side heart failure improved after pulmonary arterial pressure was reduced. Hyperthyroidism should be regarded as a reversible cause of associated pulmonary arterial hypertension.

Citations

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A Case of Pulmonary Hypertension Recurred by Graves’ Disease
Jun Seop Lee, Young Sik Choi, Jae Woo Lee, Jin Seok Yoo, Youn Jung Choi, Dong Hyun Park
Kosin Medical Journal.2013; 28(2): 171. CrossRef

Original Articles

Comparing the Prevalence of Primary Aldosteronism in Hypertensive Diabetic and Non-diabetic Patients.: Yi Sun Jang, Koon Soon Kim, Hye Soo Kim; J Korean Endocr Soc. 2009;24(4):254-259. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.254

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Abstract PDF: BACKGROUND
Primary aldosteronism is the most common cause of secondary hypertension in humans. Its prevalence is estimated to be 10-15% among hypertensive patients. It is also associated with insulin resistance and diabetes mellitus. The aim of our study was to compare the prevalence of primary aldosteronism in hypertensive patients with presence of diabetes mellitus. METHODS: We reviewed retrospectively the clinical records of 104 hypertensive patients for whom we also measured plasma renin activity (PRA) and plasma aldosterone concentrations (PAC). RESULTS: Among 104 hypertensive patients, 44 had diabetes and 60 did not. There were no significant differences in clinical characteristics between non-diabetic and diabetic patients except for age and the number of antihypertensive agents. Patients with target organ damage were more common among diabetic patients. There was no correlation between PAC and the number of target organs damaged. In addition, Four patients from the non-diabetic and two from the diabetic group had a ratio over 30 for PRA/PAC and a PAC of over 15 ng/dL. Two non-diabetic patients and one diabetic patient were found, on abdomen CT, to have an adrenal adenoma. The rest of the patients refused further tests. CONCLUSION: The prevalence of primary aldosteronism in diabetic patients does not differ significantly from that in non-diabetic patients. Therefore, the present routine screening test for primary aldosteronism in hypertensive diabetic patients is not recommended.

Comparison of Target Organ Damages between Primary Aldosteronism and Essential Hypertension.: Juri Park, Dong Jin Kim, Sae Jeong Yang, Sook Hae Kim, Soo Yeon Park, Hye Jin Yoo, Yun Jeong Lee, Hee Young Kim, Ohk Hyun Ryu, Kye Won Lee, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2007;22(1):11-18. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.11

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Abstract PDF

BACKGROUND
A number of recent clinical studies have reported marked target organ damages in patients with primary aldosteronism. The aim of this study was to compare the incidence of target organ damages in patients with primary aldosteronism (PA) and essential hypertension (EHT). METHODS: The clinical records of 41 PA patients, over a 20-year period, were retrospectively analyzed. The clinical characteristics and incidence of target organ damages of 33 of the patients in this group were compared with those of 66 patients with essential hypertension, directly matched for age, gender and mean blood pressure. 8 of the PA patients could not be matched with EHT patients for age, gender and mean blood pressure, so were excluded from the comparison. The patients with essential hypertension were sampled from patients who visited for the evaluation of hypertension. RESULTS: Ischemic heart diseases were found in 18.2 and 10.6% of patients with PA and EHT, respectively (P = 0.22). From echocardiograms, left ventricular hypertrophy was found in 93.3% and 61.4% of patients with PA and EHT, respectively (P = 0.017). The degrees of left ventricular hypertrophy were correlated with the levels of serum aldosterone, with an r value of 0.490 (P < 0.005). Cerebrovascular attack was found in 18.2% and 1.5% of patients with PA and EHT, respectively (P = 0.005). Hypertensive retinopathy was found in 50% and 33.3% of patients with PA and EHT (P = 0.255), and nephropathy was found in 42.4% and 25.8% of patients with PA and EHT, respectively (P = 0.074). CONCLUSION: Patients with primary aldosteronism had target organ damages more frequently than with those with essential hypertension, which was independent of blood pressure.

Citations

Citations to this article as recorded by

Changes in the clinical manifestations of primary aldosteronism
Sun Hwa Kim, Jae Hee Ahn, Ho Cheol Hong, Hae Yoon Choi, Yoon Jung Kim, Nam Hoon Kim, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Nan Hee Kim, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi
The Korean Journal of Internal Medicine.2014; 29(2): 217. CrossRef
Comparing the Prevalence of Primary Aldosteronism in Hypertensive Diabetic and Non-diabetic Patients
Yi Sun Jang, Koon Soon Kim, Hye Soo Kim
Journal of Korean Endocrine Society.2009; 24(4): 254. CrossRef
Aldosterone as a Cardiovascular Risk Factor
Soon Jib Yoo
Journal of Korean Endocrine Society.2007; 22(1): 8. CrossRef

Case Report

A Case of Primary Reninism Manifested by Hypertension with Hypokalemia.: Hyung Jin Choi, Eui Sil Hong, Young Min Cho, Do Joon Park, Chan Soo Shin, Kyong Soo Park, Seong Yeon Kim, Bo Youn Cho, Hong Kyu Lee; J Korean Endocr Soc. 2005;20(2):168-173. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.168

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Primary reninism is a rare cause of hypertension manifesting along with hypokalemia. A high level of plasma renin activity and a high level of serum aldosterone are the whole markers of primary reninism. Upon making the diagnosis of primary reninism, other more common causes of aldosteronism must be differentiated, such as renovascular hypertension and primary aldosteronism. Primary reninism is commonly caused by juxtaglomerular cell tumor, which is one of the curable causes of hypertension, and this can be successfully treated by conservative surgery. We report here on a case of primary reninism that was caused by juxtaglomerular cell tumor that developed in a 22-year-old female patient. She was recently diagnosed with hypertension and hypokalemia. She had markedly elevated plasma renin activity and an increased serum aldosterone concentration. Computed tomography revealed a mass located in the right kidney and selective renal vein sampling suggested that the mass was secreting an excess of renin. Right nephrectomy was done and her hypertension with hypokalemia was successfully treated. We report here a case of primary reninism that presented with juxtaglomerular cell tumor along with a review of the literature

Citations

Citations to this article as recorded by

Reninoma: a rare cause of curable hypertension
Ji Hye Kim, Ji Hyun Kim, Myung Hyun Cho, Eujin Park, Hye Sun Hyun, Yo Han Ahn, Hee Gyung Kang, Kyung Chul Moon, Il-Soo Ha, Hae Il Cheong
Korean Journal of Pediatrics.2019; 62(4): 144. CrossRef

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