Qu Huiyun, Zhao Jingge, Wang Lulu, Du Huiyu, Zhang Qinghui, Sun Tingxi, Zhang Chen, Chen Jiaxuan, Guo Linya, Huang Qi, Tian Dandan, Liu Zhilan, Hao Yibin, Liu Min
Department of Hypertension, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China.
Clinical Research Centre, Henan Provincial People's Hospital, Zhengzhou, China.
Front Endocrinol (Lausanne). 2024 Dec 6;15:1506814. doi: 10.3389/fendo.2024.1506814. eCollection 2024.
The clinical biochemical characteristics and target organ damage (TOD) in patients with plasma aldosterone concentrations (PAC) ranging from 50 to 100 ng/L after a saline infusion test (SIT) have not been fully studied.
A total of 611 hypertensive patients with an elevated aldosterone-to-renin ratio (ARR) who underwent a supine SIT at Henan Provincial People's Hospital were enrolled. The patients were divided into three groups according to their post-SIT PAC: <50 ng/L (control group), 50-100 ng/L (indeterminate post-SIT results group), and >100 ng/L (PA group). The clinical and biochemical characteristics and TOD of the three groups were compared. The correlation of the post-SIT PAC with left ventricular mass index (LVMI) was assessed via regression analysis.
The indeterminate post-SIT results group had the youngest patients and the shortest duration of hypertension. The prevalence of renal impairment (RI) and left ventricular hypertrophy (LVH) was lower than that in the PA group (P<0.05), but there was no statistically significant difference from the control group (P>0.05). After adjustment for confounders, the risk of developing carotid plaque was greater in the indeterminate post-SIT results group than in the control group (OR 1.73, 95% CI: 1.11, 2.69), and the prevalence of RI and LVH tended to increase with increasing post-SIT PAC levels. In multiple regression analyses, LVMI was significantly correlated with post-SIT PAC (P<0.05), but the basal PAC, plasma renin activity, and ARR did not significantly correlate with LVMI (P>0.05).
A post-SIT PAC of 50-100 ng/L may be indicative of an early form of PA, and it may serve as an independent predictor of LVH, which could be related to the level of autonomously secreted aldosterone.
盐水输注试验（SIT）后血浆醛固酮浓度（PAC）在50至100 ng/L之间的患者的临床生化特征和靶器官损害（TOD）尚未得到充分研究。
纳入河南省人民医院611例醛固酮/肾素比值（ARR）升高且接受仰卧位SIT的高血压患者。根据SIT后的PAC将患者分为三组：<50 ng/L（对照组）、50 - 100 ng/L（SIT结果不确定组）和>100 ng/L（原发性醛固酮增多症组）。比较三组的临床和生化特征及TOD。通过回归分析评估SIT后的PAC与左心室质量指数（LVMI）的相关性。
SIT结果不确定组患者最年轻，高血压病程最短。肾功能损害（RI）和左心室肥厚（LVH）的患病率低于原发性醛固酮增多症组（P<0.05），但与对照组无统计学显著差异（P>0.05）。调整混杂因素后，SIT结果不确定组发生颈动脉斑块的风险高于对照组（OR 1.73，95%CI：1.11，2.69），RI和LVH的患病率倾向于随SIT后PAC水平升高而增加。在多元回归分析中，LVMI与SIT后的PAC显著相关（P<0.05），但基础PAC、血浆肾素活性和ARR与LVMI无显著相关性（P>0.05）。
SIT后的PAC为50 - 100 ng/L可能提示原发性醛固酮增多症的早期形式，且可能作为LVH的独立预测指标，这可能与自主分泌的醛固酮水平有关。
