Shibayama Yui, Wada Norio, Baba Shuhei, Miyano Yukie, Obara Shinji, Iwasaki Ren, Nakajima Haruka, Sakai Hidetsugu, Usubuchi Hiroaki, Terae Satoshi, Nakamura Akinobu, Atsumi Tatsuya
Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan.
Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
J Endocr Soc. 2018 Sep 17;2(11):1236-1245. doi: 10.1210/js.2018-00187. eCollection 2018 Nov 1.
The involvement of visceral fat in aldosterone secretion has not been reported in patients with primary aldosteronism (PA). Patients with PA are complicated by metabolic syndrome more frequently than those without PA. An excess of visceral fat has been hypothesized to cause an elevation of aldosterone secretion in patients with PA.
To clarify the role of visceral fat in the pathophysiology of PA, we investigated the correlation between plasma aldosterone concentration (PAC) and visceral fat parameters in patients with PA.
This retrospective observational study comprised 131 patients diagnosed with PA between April 2007 and April 2017 at Sapporo City General Hospital. We divided participants into two PA subtypes, aldosterone-producing adenoma (APA; n = 47) and idiopathic hyperaldosteronism (IHA, n = 84), utilizing adrenal venous sampling. We analyzed the correlations of PAC with visceral fat percentage (VF%), visceral fat area (VFA), and subcutaneous fat area, by evaluating computed tomography studies in each subtype group.
Patients with IHA showed a positive correlation of PAC with VF% ( = 0.377, < 0.001) and VFA ( = 0.443, < 0.001). The correlation was not evident in patients with APA.
This study revealed a relationship between visceral adipose tissue and aldosterone production only in patients with IHA.
原发性醛固酮增多症(PA)患者内脏脂肪与醛固酮分泌之间的关系尚未见报道。PA患者比非PA患者更常并发代谢综合征。据推测,内脏脂肪过多会导致PA患者醛固酮分泌升高。
为阐明内脏脂肪在PA病理生理学中的作用,我们研究了PA患者血浆醛固酮浓度(PAC)与内脏脂肪参数之间的相关性。
这项回顾性观察性研究纳入了2007年4月至2017年4月在札幌市立综合医院诊断为PA的131例患者。我们利用肾上腺静脉采血将参与者分为两个PA亚型,即醛固酮瘤(APA;n = 47)和特发性醛固酮增多症(IHA,n = 84)。通过评估各亚型组的计算机断层扫描研究,我们分析了PAC与内脏脂肪百分比(VF%)、内脏脂肪面积(VFA)和皮下脂肪面积之间的相关性。
IHA患者的PAC与VF%( = 0.377, < 0.001)和VFA( = 0.443, < 0.001)呈正相关。在APA患者中,这种相关性不明显。
本研究仅揭示了IHA患者内脏脂肪组织与醛固酮产生之间的关系。