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DOI: 10.1055/s-0029-1246189
© Georg Thieme Verlag KG Stuttgart · New York
Is Primary Aldosteronism Associated with Diabetes Mellitus? Results of the German Conn's Registry
Publikationsverlauf
received 22.10.2009
accepted 15.12.2009
Publikationsdatum:
29. Januar 2010 (online)
Abstract
Aldosterone excess in the context of primary aldosteronism (PA) has been associated with impaired glucose tolerance and diabetes mellitus. We retrospectively assessed the prevalence of diabetes mellitus in patients from the German Conn's Register and compared the data with those from hypertensive subjects of a population-based survey. In a case-control study, we have compared 638 patients with PA from the German Conn's registry who were treated in 6 German centers with 897 hypertensive control subjects from the population-based F3 survey of the Cooperative Health Research in the Region of Augsburg (KORA). The samples were matched for age, sex, and blood pressure in a 1:1 ratio. Risk factors associated with the presence of diabetes mellitus were calculated in 638 patients with PA and 897 hypertensive controls. In the case control study, the diabetes prevalence was calculated in 338 cases and controls. In patients with primary aldosteronism, age, BMI, and a higher number of antihypertensive drugs (lowest tertile vs. highest tertile) were variables associated with diabetes mellitus. In contrast, serum potassium and plasma aldosterone concentrations were not associated with higher diabetes prevalence, whereas diastolic blood pressure was inversely associated with diabetes mellitus. Diabetes mellitus was more prevalent in patients with PA than in 338 matched controls (23 vs. 10% in controls). Our data for the German population show that diabetes mellitus is more prevalent in patients with primary aldosteronism than in hypertensive controls.
Key words
aldosterone - adrenal - mineralocorticoid
References
- 1 Van Gaal LF, Mertens IL, De Block CE. Mechanisms linking obesity with cardiovascular disease. Nature. 2006; 444 875-880
- 2 Krug AW, Ehrhart-Bornstein M. Adrenocortical dysfunction in obesity and the metabolic syndrome. Horm Metab Res. 2008; 40 515-517
- 3 Sowers JR, Whaley-Connell A, Epstein M. Narrative review: the emerging clinical implications of the role of aldosterone in the metabolic syndrome and resistant hypertension. Ann Intern Med. 2009; 150 776-783
- 4 Cooper SA, Whaley-Connell A, Habibi J, Wei Y, Lastra G, Manrique C, Stas S, Sowers JR. Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance. Am J Physiol Heart Circ Physiol. 2007; 293 H2009-H2023
- 5 Colussi G, Catena C, Lapenna R, Nadalini E, Chiuch A, Sechi LA. Insulin resistance and hyperinsulinemia are related to plasma aldosterone levels in hypertensive patients. Diabetes Care. 2007; 30 2349-2354
- 6 Schirpenbach C, Reincke M. Primary aldosteronism: current knowledge and controversies in Conn's syndrome. Nat Clin Pract Endocrinol Metab. 2007; 3 220-227
- 7 Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, Young Jr WF, Montori VM. Endocrine Society Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93 3266-3281
- 8 Ishimori M, Takeda N, Okumura S, Murai T, Inouye H, Yasuda K. Increased insulin sensitivity in patients with aldosterone producing adenoma. Clin Endocrinol (Oxf). 1994; 41 433-448
- 9 Sindelka G, Widimský J, Haas T, Prázný M, Hilgertová J, Skrha J. Insulin action in primary hyperaldosteronism before and after surgical or pharmacological treatment. Exp Clin Endocrinol Diabetes. 2000; 108 21-25
- 10 Kreze Sr. A, Kreze-Spirova E, Mikulecky M. Diabetes mellitus in primary aldosteronism. Bratisl Lek Listy. 2000; 101 187-190
- 11 Strauch B, Widimský J, Sindelka G, Skrha J. Does the treatment of primary hyperaldosteronism influence glucose tolerance?. Physiol Res. 2003; 52 503-506
- 12 Skrha J, Haas T, Sindelka G, Prázný M, Widimský J, Cibula D, Svacina S. Comparison of the insulin action parameters from hyperinsulinemic clamps with homeostasis model assessment and QUICKI indexes in subjects with different endocrine disorders. J Clin Endocrinol Metab. 2004; 89 135-141
- 13 Fallo F, Veglio F, Bertello C, Sonino N, Della Mea P, Ermani M, Rabbia F, Federspil G, Mulatero P. Prevalence and characteristics of the metabolic syndrome in primary aldosteronism. J Clin Endocrinol Metab. 2006; 91 454-459
- 14 Sasaki N, Iwase M, Arima H, Nohara S, Bandai S, Yao T, Fujii K, Iida M. Overt diabetes mellitus in a patient with combined primary aldosteronism and Cushing's syndrome. Intern Med. 2006; 45 1237-1242
- 15 Catena C, Lapenna R, Baroselli S, Nadalini E, Colussi G, Novello M, Favret G, Melis A, Cavarape A, Sechi LA. Insulin sensitivity in patients with primary aldosteronism: a follow-up study. J Clin Endocrinol Metab. 2006; 91 3457-3463
- 16 Mosso LM, Carvajal CA, Maiz A, Ortiz EH, Castillo CR, Artigas RA, Fardella CE. A possible association between primary aldosteronism and a lower beta-cell function. J Hypertens. 2007; 25 2125-2130
- 17 Giacchetti G, Ronconi V, Turchi F, Agostinelli L, Mantero F, Rilli S, Boscaro M. Aldosterone as a key mediator of the cardiometabolic syndrome in primary aldosteronism: an observational study. J Hypertens. 2007; 25 177-1786
- 18 Colussi G, Catena C, Lapenna R, Nadalini E, Chiuch A, Sechi LA. Insulin resistance and hyperinsulinemia are related to plasma aldosterone levels in hypertensive patients. Diabetes Care. 2007; 30 2349-2354
- 19 Matrozova J, Steichen O, Amar L, Zacharieva S, Jeunemaitre X, Plouin PF. Fasting plasma glucose and serum lipids in patients with primary aldosteronism: a controlled cross-sectional study. Hypertension. 2009; 53 605-610
- 20 Corry DB, Tuck ML. effect of aldosterone on glucose metabolism. Curr Hypertens Rep. 2003; 5 106-109
- 21 Fallo F, Federspil G, Veglio F, Mulatero P. The metabolic syndrome in primary aldosteronism. Curr Diab Rep. 2008; 8 42-47
- 22 Reincke M, Rump LC, Quinkler M, Hahner S, Diederich S, Lorenz R, Seufert J, Schirpenbach C, Beuschlein F, Bidlingmaier M, Meisinger C, Holle R, Endres S. Risk factors associated with a low glomerular filtration rate in primary aldosteronism. Participants of German Conn's Registry. J Clin Endocrinol Metab. 2009; 94 869-875
- 23 Born-Frontsberg E, Reincke M, Rump LC, Hahner S, Diederich S, Lorenz R, Allolio B, Seufert J, Schirpenbach C, Beuschlein F, Bidlingmaier M, Endres S, Quinkler M. Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German Conn's Registry. Participants of the German Conn's Registry. J Clin Endocrinol Metab. 2009; 94 1125-1130
- 24 Schirpenbach C, Segmiller F, Diederich S, Hahner S, Lorenz R, Rump LC, Seufert J, Quinkler M, Bidlingmaier M, Beuschlein F, Endres S, Reincke M. The diagnosis and treatment of primary hyperaldosteronism in Germany: results on 555 patients from the German Conn's Registry. Dtsch Arztebl Int. 2009; 106 305-311
- 25 Born-Frontsberg E, Reincke M, Beuschlein F, Quinkler M. Participants of German Conn's Registry Tumor size of Conn's adenoma and comorbidities. Horm Metab Res. 2009; 41 785-788
- 26 Löwel H, Döring A, Schneider A, Heier M, Thorand B, Meisinger C. MONICA/KORA Study Group The MONICA Augsburg surveys – basis for prospective cohort studies. Gesundheitswesen. 2005; 67 ((Suppl 1)) S13-S18
- 27 Jefic D, Mohiuddin N, Alsabbagh R, Fadanelli M, Steigerwalt S. The prevalence of primary aldosteronism in diabetic patients. J Clin Hypertens (Greenwich). 2006; 8 253-256
- 28 Stump CS, Hamilton MT, Sowers JR. Effect of antihypertensive agents on the development of type 2 diabetes mellitus. Mayo Clin Proc. 2006; 81 796-806
Correspondence
Prof. Dr. M. Reincke
Medizinische Klinik – Innenstadt Klinikum der Universität München
Ziemssenstraße 1
80336 München
Germany
Telefon: +49 89 5160 2100
Fax: +49 89 5160 4428
eMail: martin.reincke@med.uni-muenchen.de