Buglioni Alessia, Cannone Valentina, Sangaralingham S Jeson, Heublein Denise M, Scott Christopher G, Bailey Kent R, Rodeheffer Richard J, Sarzani Riccardo, Burnett John C
Cardiorenal Research Laboratory, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., J.C.B.) Division of Cardiovascular Diseases, Department of Medicine, College of Medicine Mayo Clinic, Rochester, MN (A.B., V.C., J.S., D.M.H., R.J.R., J.C.B.).
Department of Health Sciences Research, College of Medicine Mayo Clinic, Rochester, MN (C.G.S., K.R.B.).
J Am Heart Assoc. 2015 Dec 23;4(12):e002505. doi: 10.1161/JAHA.115.002505.
We recently reported that normal aldosterone levels are associated with cardiovascular, renal, and metabolic disease in a sample of the US general community (Visit 1). For the current analyses we used the same cohort in a new 4-year follow-up study (Visit 2).
We measured aldosterone at Visit 1 and analyzed its predictive role for new diseases at Visit 2 (n=1140). We measured aldosterone at Visit 2 and investigated its associations with disease at Visit 2 (n=1368). We analyzed aldosterone continuously and we also dichotomized the variable as whether subjects were in the third tertile versus second and first tertiles. As continuous variable at Visit 1, aldosterone predicted new onset hypertension (HTN) (OR=1.36, CI=1.13-1.63, P=0.001), central obesity (OR=1.36, CI=1.07-1.73, P=0.011), and use of lipid-lowering drugs (OR=1.25, CI=1.05-1.48, P=0.012) at Visit 2, after adjustment for age, sex, and body mass index. When in the third tertile (8.5-88.6 ng/dL), aldosterone predicted type 2 diabetes (T2DM, OR=1.96, CI=1.03-3.70, P=0.039). At Visit 2, aldosterone remained associated with HTN, obesity, and chronic kidney disease (CKD), as reported for Visit 1. However, aldosterone was not associated with heart failure (HF) at Visit 1 and 2, nor was aldosterone a predictor of HF between visits.
Aldosterone predicts new HTN, central obesity, T2DM, and use of lipid-lowering drugs in the general community and remains associated with HTN, obesity, and CKD over 4 years. Aldosterone is not associated nor predicts HF. Further studies are warranted to evaluate aldosterone as therapeutic target in the general community.
我们最近报告称，在美国普通社区样本（访视1）中，正常醛固酮水平与心血管、肾脏和代谢疾病相关。在当前分析中，我们在一项新的4年随访研究（访视2）中使用了同一队列。
我们在访视1时测量醛固酮，并分析其对访视2时新发病的预测作用（n = 1140）。我们在访视2时测量醛固酮，并研究其与访视2时疾病的关联（n = 1368）。我们对醛固酮进行连续分析，并且还将该变量二分，即受试者是否处于第三三分位数与第二和第一三分位数。作为访视1时的连续变量，在调整年龄、性别和体重指数后，醛固酮可预测访视2时新发高血压（HTN）（OR = 1.36，CI = 1.13 - 1.63，P = 0.001）、中心性肥胖（OR = 1.36，CI = 1.07 - 1.73，P = 0.011）以及降脂药物的使用（OR = 1.25，CI =1.05 - 1.48，P = 0.012）。当处于第三三分位数（8.5 - 88.6 ng/dL）时，醛固酮可预测2型糖尿病（T2DM，OR = 1.96，CI = 1.03 - 3.70，P = 0.039）。如访视1所报告的那样，在访视2时，醛固酮仍与HTN、肥胖和慢性肾脏病（CKD）相关。然而，在访视1和访视2时，醛固酮与心力衰竭（HF）均无关联，且醛固酮也不是访视间HF的预测指标。
醛固酮可预测普通社区中新发的HTN、中心性肥胖、T2DM和降脂药物的使用，并且在4年期间仍与HTN、肥胖和CKD相关。醛固酮与HF无关联，也不能预测HF。有必要进一步开展研究以评估醛固酮作为普通社区治疗靶点的情况。
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