Journal Title
Title of Journal: Endocrine
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Authors: Christian Adolf Evelyn Asbach Anna Stephanie Dietz Katharina Lang Stefanie Hahner Marcus Quinkler Lars Christian Rump Martin Bidlingmaier Marcus Treitl Roland Ladurner Felix Beuschlein Martin Reincke
Publish Date: 2016/05/14
Volume: 54, Issue: 1, Pages: 198-205
Abstract
Primary aldosteronism PA describes the most frequent cause of secondary arterial hypertension Recently deterioration of lipid metabolism after adrenalectomy ADX for aldosteroneproducing adenoma APA has been described We analysed longitudinal changes in lipid profiles in a large prospective cohort of PA patients Data of 215 consecutive PA patients with APA n = 144 or bilateral idiopathic adrenal hyperplasia IHA n = 71 were extracted from the database of the German Conn’s Registry Patients were investigated before and 1 year after successful treatment by ADX or by mineralocorticoid receptor antagonists MRA Glomerular filtration rate GFR fasting plasma glucose and components of lipid metabolism including triglycerides TG total cholesterol TC lowdensity lipoprotein cholesterol LDLC and highdensity lipoprotein cholesterol HDLC were determined at 800 after a 12h fasting period One year after initiation of treatment mean serum potassium levels and blood pressure normalized in the patients HDLC and TG developed inversely with decreasing HDLC levels in patients with APA p = 046 and IHA p = 004 and increasing TG levels APA p = 000 IHA p = 020 BMI remained unchanged and fasting plasma glucose improved in patients with APA p = 004 Furthermore there was a significant decrease of GFR in both subgroups at followup p = 000 Changes in HDLC and TG correlated with decrease in GFR in multivariate analysis p = 024 Treatment of PA is associated with a deterioration of lipid parameters despite stable BMI and improved fasting plasma glucose and blood pressure This effect can be explained by renal dysfunction following ADX or MRA therapyThe study was only feasible due to the support of our PA team the Endocrine laboratory team in Munich and our collaborators in the other centres This work has been supported by the Else KrönerFresenius Stiftung German Conn’s RegistryElse KrönerFreseniusHyperaldosteronism Registry 2015 A171 to MR
Keywords:
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