Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Renin Angiotensin Aldosterone Syst. 2011 Sep;12(3):348-57. doi: 10.1177/1470320310391329. Epub 2011 Mar 10.
Current data on primary aldosteronism (PA) from Asian populations are scarce. This cohort study clarifies the attributes of patients with PA in a typical Chinese population.
An observational cohort study.
The records of patients referred to the Hypertension Clinic from a multi-centre registration in Taiwan from January 1995 to December 2007 were reviewed. All patients with PA were classified into two subtypes: aldosterone-producing adenomas (APA) and idiopathic hyperaldosteronism (IHA); their characteristics were compared.
Our cohort consisted of 346 patients with PA, 255 with APA and 91 with IHA. The initial hypokalaemia (59% in APA vs. 27.5% in IHA, p < 0.0001) and transtubular potassium gradient (TTKG) (6.30 ± 2.41 in APA vs. 4.91 ± 2.03 in IHA, p = 0.01) were higher in the APA group. Baseline plasma aldosterone concentration (PAC) was also significantly different between the two subgroups (49.96 ± 38.15 ng/dl in APA vs. 34.24 ± 21.47 in IHA, p < 0.0001).
In typical Chinese PA patients, the APA subgroup had a higher proportion of hypokalaemia with elevated TTKG and higher PAC as compared with the IHA subgroup. This largest Asian database also demonstrated major differences between the Caucasian and Chinese populations including female predilection, frequent hypokalaemia, and common paralytic myopathy.
目前亚洲人群原发性醛固酮增多症（PA）的数据较为匮乏。本队列研究阐明了典型中国人群中 PA 患者的特征。
观察性队列研究。
对 1995 年 1 月至 2007 年 12 月台湾多中心登记处转诊至高血压门诊的患者记录进行了回顾。将所有 PA 患者分为醛固酮瘤（APA）和特发性醛固酮增多症（IHA）两种亚型；比较其特征。
本队列共纳入 346 例 PA 患者，其中 255 例为 APA，91 例为 IHA。APA 组初始低钾血症（59% vs. IHA 组 27.5%，p<0.0001）和肾小管钾梯度（TTKG）（6.30±2.41 vs. IHA 组 4.91±2.03，p=0.01）更高。两组间基础血浆醛固酮浓度（PAC）也存在显著差异（APA 组 49.96±38.15 ng/dl vs. IHA 组 34.24±21.47 ng/dl，p<0.0001）。
在典型的中国 PA 患者中，与 IHA 亚组相比，APA 亚组低钾血症伴 TTKG 升高和 PAC 更高的比例更高。这个最大的亚洲数据库还显示了白种人和中国人之间的主要差异，包括女性倾向、低钾血症常见和常见的麻痹性肌病。
