Adipokines and cardiometabolic profile in primary hyperaldosteronism

J Clin Endocrinol Metab. 2010 May;95(5):2391-8. doi: 10.1210/jc.2009-2204. Epub 2010 Mar 1.

Abstract

Context: Primary aldosteronism (PA) has been recently associated with an unfavorable cardiometabolic profile. However, whether pro- and antiinflammatory adipokines levels can vary in PA is unknown.

Objective: We evaluated the circulating levels of resistin, leptin, and adiponectin, echocardiographic left ventricle (LV) parameters, and the prevalence of metabolic syndrome (SM) in subjects with PA.

Patients: Seventy-five subjects with established diagnosis of PA and 232 consecutive individuals with known or suspected hypertension were enrolled.

Main outcome measures: Plasma adipokine levels and echocardiographic parameters were calculated. Prevalence of SM was also estimated.

Results: Among the 75 PA subjects, 37 patients were affected by aldosterone-producing adenoma and 38 by idiopathic hyperaldosteronism; 40 subjects were affected by essential hypertension (EH) and SM (EH SM+); 152 subjects were affected by EH without SM (EH SM-); and 40 subjects were normotensive (NT). Subjects with PA had the highest plasma resistin levels among the four groups (P < 0.01). Plasma resistin concentration was significantly higher in PA subjects when compared with EH SM+ individuals (P < 0.01) and EH SM- subjects (P < 0.01). PA subjects showed the higher LV mass and left atrium than EH individuals, irrespectively of the presence of SM (P < 0.01 for both). Plasma resistin levels was significantly correlated with ejection fraction and LV end-diastolic volume. The prevalence of SM was higher in PA subjects than in those with EH (25.4 vs. 20.3%).

Conclusions: Our data suggest that elevated aldosterone levels is associated with elevated circulating resistin levels and cardiac morphological changes independently of the presence of SM.

MeSH terms

  • Adenoma / complications
  • Adenoma / metabolism
  • Adiponectin / blood*
  • Adult
  • Aged
  • Aldosterone / blood*
  • Aldosterone / metabolism
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • C-Reactive Protein / metabolism
  • Cholesterol / blood
  • Echocardiography
  • Female
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Hyperaldosteronism / blood*
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / diagnostic imaging
  • Hypertension / complications
  • Leptin / blood*
  • Male
  • Metabolic Syndrome / complications
  • Middle Aged
  • Resistin / blood*
  • Young Adult

Substances

  • Adiponectin
  • Biomarkers
  • Blood Glucose
  • Leptin
  • Resistin
  • Aldosterone
  • C-Reactive Protein
  • Cholesterol