Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma. Issue 1 (26th July 2020)

• Record Type: Journal Article
• Authors: Er, Leay Kiaw; Lin, Meng-Chun; Tsai, Yao-Chou; Hsiao, Jong-Kai; Yang, Chung-Yi; Chang, Chin-Chen; Peng, Kang-Yung; Chueh, Jeff S; Wu, Vin-Cent
• Other Names: author non-byline.; Lai Tai-Shuan author non-byline.; Yang Shao-Yu author non-byline.; Liu Kao-Lang author non-byline.; Chang Chin-Chen author non-byline.; Lee Bo-Chiag author non-byline.; Wang Shuo-Meng author non-byline.; Huang Kuo-How author non-byline.; Lin Po-Chih author non-byline.; Lin Yen-Hung author non-byline.; Lin Lian-Yu author non-byline.; Liao Shih-Cheng author non-byline.; Yen Ruoh-Fang author non-byline.; Lu Ching-Chu author non-byline.; Chan Chieh-Kai author non-byline.; Er Leay-Kiaw author non-byline.; Hu Ya-Hui author non-byline.; Chang Chia-Hui author non-byline.; Wu Che-Hsiung author non-byline.; Tsai Yao-Chou author non-byline.; Chueh Shih-Chieh Jeff author non-byline.; Ho Chen-Hsun author non-byline.; Huang Wei-Chieh author non-byline.; Chen Ying-Ying author non-byline.; Wu Vin-Cent author non-byline.
• Is Part Of: BMJ open diabetes research and care. Volume 8:Issue 1(2020)
• Publication Date: 2020-07-26
• Subjects: adipocyte -- adipocyte secretion -- adipocytes - metabolism -- adipose tissue; Diabetes -- Periodicals; 616.462005
• DOI: 10.1136/bmjdrc-2019-001153
• Languages: English
• ISSNs: 2052-4897

Abstract

Abstract : Introduction: Primary aldosteronism (PA) is a common form of secondary hypertension that has significant cardiovascular events and increased prevalence of metabolic syndrome and diabetics. Although plasma aldosterone concentration is positively correlated with visceral fat area (VFA) in non-PA individuals, the role of visceral adiposity associated with clinical success after surgery is not known. Research design and methods: We analyzed patients who underwent adrenalectomy for aldosterone-producing adenoma (APA) at the Taiwan PA Investigator group. VFA was calculated from the abdominal CT scan at APA diagnosis, and all patients received adrenalectomy. Results: The study involved 100 consecutive patients with APA (42 males; mean age 49.3 years) matched with 41 essential hypertension (EH) patients. Patients with APA had smaller VFA (p=0.010) than their EH counterparts. Multiple linear regression analysis revealed that the duration of hypertension (p=0.007), but not plasma aldosterone, was negatively correlated with VFA in patients with APA. Logistic regression analysis showed that log VFA (OR=0.065, p < 0.001) and duration of hypertension before PA diagnosis (OR=0.919, p=0.011) can predict complete clinical success after adrenalectomy. Multifactor-adjusted generalized additive model demonstrated that log VFA <9.2 was associated with complete cure of hypertension. Furthermore, VFA was increased at 6 months after adrenalectomy (p=0.045). Conclusions: Patients with APA had smaller VFA than their EH counterparts, and VFA increased after adrenalectomy. Clinical complete cure of hypertension after surgery was associated with smaller VFA and shorter duration of hypertension at PA diagnosis, suggesting a potential interplay of visceral adiposity and aldosterone of the patients with APA.