Department of Diabetes and Endocrinology, Sapporo City General Hospital, 060-8604 Sapporo, Japan.
Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, 060-8648 Sapporo, Japan.
Endocr J. 2020 Jun 29;67(6):623-629. doi: 10.1507/endocrj.EJ19-0600. Epub 2020 Mar 24.
Patients with primary aldosteronism (PA) are complicated by metabolic syndrome more frequently than those without PA. Hyperaldosteronism has been reported to be associated with a higher prevalence of non-alcoholic fatty liver disease (NAFLD). We aimed to clarify the risk factors for hepatic steatosis in the two subtypes of PA, comparing the status of hepatic steatosis in each of these subtypes. This was a retrospective observational study. We enrolled patients with an aldosterone producing adenoma (APA) (n = 33) or idiopathic hyperaldosteronism (IHA) (n = 56). Hepatic fat content was evaluated using the ratio of liver to spleen (L/S) X-ray attenuation on unenhanced computed tomography. L/S ratio <1.0 was utilized for assessing as hepatic steatosis. Age, sex distribution, visceral fat percentage (VF%), and visceral fat area (VFA) did not differ between patients with the two PA subtypes. The percentages of patients with L/S ratio <1.0 was not different between the two subtypes (APA: 21.2 % (7/33) vs. IHA: 19.6 % (11/56), p = 1.00). In both subtypes, the L/S ratio negatively correlated with VF% (APA: r = -0.66, p < 0.001; IHA: r = -0.66, p < 0.001) and with VFA (APA: r = -0.44, p < 0.01; IHA: r = -0.37, p < 0.01). The status of hepatic steatosis, evaluated using L/S ratio, did not differ between patients with APA or IHA. Hepatic steatosis was affected by the amount of visceral fat.
原醛症（PA）患者比无 PA 患者更常合并代谢综合征。高醛固酮血症与非酒精性脂肪肝疾病（NAFLD）的患病率较高有关。我们旨在阐明两种 PA 亚型中肝脂肪变性的危险因素，并比较这些亚型中肝脂肪变性的状态。这是一项回顾性观察性研究。我们招募了醛固酮分泌腺瘤（APA）（n = 33）或特发性醛固酮增多症（IHA）（n = 56）患者。使用未增强 CT 上肝脏与脾脏（L/S）衰减比评估肝脂肪含量。L/S 比值<1.0 用于评估肝脂肪变性。PA 两种亚型患者的年龄、性别分布、内脏脂肪百分比（VF%）和内脏脂肪面积（VFA）无差异。两种亚型患者的 L/S 比值<1.0 的比例无差异（APA：21.2%（7/33）与 IHA：19.6%（11/56），p = 1.00）。在两种亚型中，L/S 比值与 VF%呈负相关（APA：r = -0.66，p<0.001；IHA：r = -0.66，p<0.001），与 VFA 呈负相关（APA：r = -0.44，p<0.01；IHA：r = -0.37，p<0.01）。使用 L/S 比值评估的肝脂肪变性状态在 APA 或 IHA 患者之间无差异。肝脂肪变性受内脏脂肪量的影响。
