van den Berg T N A Daniëlle, Meijers Wouter C, Donders A Rogier T, Van Herwaarden Antonius E, Rongen Gerard A, de Boer Rudolf A, Deinum Jaap, Riksen Niels P
aDepartment of Pharmacology and Toxicology bDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen cDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen dDepartment for Health Evidence eDepartment of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
J Hypertens. 2017 Sep;35(9):1849-1856. doi: 10.1097/HJH.0000000000001383.
The incidence of cardiovascular events is higher in patients with primary aldosteronism than in patients with essential hypertension (EHT), despite similar blood pressure levels. This suggests detrimental cardiovascular effects of aldosterone. Amongst others, it has been suggested that galectin-3 (Gal-3) is a key mediator in aldosterone-induced myocardial fibrosis.
We studied whether patients with primary aldosteronism have higher plasma Gal-3 concentrations than patients with EHT and evaluated its reversibility after adrenalectomy.
In a retrospective cohort from our tertiary referral centre, we measured plasma Gal-3 concentrations in 78 patients with primary aldosteronism, 39 cured primary aldosteronism patients after adrenalectomy and 56 patients with EHT. Paired samples were available in 11 patients (preadrenalectomy and postadrenalectomy). We compared plasma Gal-3 levels by univariate analysis of covariance with correction for cardiovascular risk factors, plasma creatinine concentration, plasma potassium levels and alcohol intake.
Adjusted plasma Gal-3 concentrations in patients with primary aldosteronism, patients after adrenalectomy and patients with EHT were 11.39 ± 0.60, 11.64 ± 0.81 and 11.41 ± 0.73 ng/ml, respectively (mean ± SD; P = 0.95). In 11 patients of whom paired samples were available, mean Gal-3 concentrations increased from 10.03 ± 1.67 ng/ml preadrenalectomy to 14.36 ± 2.07 ng/ml postadrenalectomy (P < 0.01).
In patients with primary aldosteronism, plasma Gal-3 concentrations are not elevated when compared with patients with EHT, and levels do not decrease after adrenalectomy. These results are in contrast to previous studies and do not support a pathophysiological role of plasma Gal-3 in the increased cardiovascular risk in patients with primary aldosteronism.
尽管原发性醛固酮增多症患者与原发性高血压（EHT）患者血压水平相似，但前者心血管事件的发生率更高。这表明醛固酮对心血管有有害影响。其中，有人提出半乳糖凝集素-3（Gal-3）是醛固酮诱导心肌纤维化的关键介质。
我们研究原发性醛固酮增多症患者的血浆Gal-3浓度是否高于EHT患者，并评估肾上腺切除术后其可逆性。
在我们三级转诊中心的一项回顾性队列研究中，我们测量了78例原发性醛固酮增多症患者、39例肾上腺切除术后治愈的原发性醛固酮增多症患者和56例EHT患者的血浆Gal-3浓度。11例患者有配对样本（肾上腺切除术前和术后）。我们通过协方差单变量分析比较血浆Gal-3水平，并校正心血管危险因素、血浆肌酐浓度、血浆钾水平和酒精摄入量。
原发性醛固酮增多症患者、肾上腺切除术后患者和EHT患者的校正血浆Gal-3浓度分别为11.39±0.60、11.64±0.81和11.41±0.73 ng/ml（均值±标准差；P = 0.95）。在有配对样本的11例患者中，Gal-3平均浓度从肾上腺切除术前的10.03±1.67 ng/ml增加到肾上腺切除术后的14.36±2.07 ng/ml（P < 0.01）。
与EHT患者相比，原发性醛固酮增多症患者的血浆Gal-3浓度没有升高，肾上腺切除术后水平也没有降低。这些结果与先前的研究相反，不支持血浆Gal-3在原发性醛固酮增多症患者心血管风险增加中的病理生理作用。
