Tizianel Irene, Madinelli Alberto, Crimì Filippo, Barbot Mattia, Censi Simona, Sabbadin Chiara, Ceccato Filippo
Department of Medicine DIMED, Endocrine Unit, Padua, Italy.
Endocrine Unit, University-Hospital of Padova, Padua, Italy.
Clin Endocrinol (Oxf). 2025 Jun;102(6):618-625. doi: 10.1111/cen.15231. Epub 2025 Mar 13.
To assess the prevalence of metabolic associated steatotic liver disease (MASLD) in patients with primary aldosteronism (PA) compared to benign adrenal adenomas, and to evaluate the impact of hormonal excess in inducing MASLD.
Single-centre retrospective study.
Hepatic steatosis was assessed by liver/spleen (L/S) ratio from unenhanced abdomen computed tomography images (reference value < 1.1) in a cohort of 41 patients with PA without cortisol cosecretion, 20 unilateral (uPA) and 21 bilateral (BPA), 50 with nonfunctioning adrenal incidentalomas (NF-AI), 48 with mild autonomous cortisol secretion (MACS) and 10 with adrenal Cushing Syndrome (CS).
Hepatic steatosis was increased in patients with PA at diagnosis: L/S ratio was lower in PA than NF-AI (1.1 vs. 1.25, p < 0.001) and MACS (1.1 vs. 1.21, p 0.007), but was similar to adrenal CS (1.1 vs. 1.15, p = 0.147). A improvement in L/S ratio after medical or surgical treatment was observed in PA patients, resulting in reduced liver steatosis. MASLD prevalence was higher in PA compared to MACS (49% vs. 25%, p < 0.05) and NF-AI (49% vs. 14%, p < 0.001), but similar to CS (49% vs. 45%, p = 0.61). uPA patients had higher MASLD prevalence compared to BPA group 71% (53%-89%) versus 25% (7%-43%).
Prevalence of MASLD was increased in PA (higher in uPA than BPA) compared to MACS and NFAI, and similar to adrenal CS.
评估原发性醛固酮增多症（PA）患者与良性肾上腺腺瘤患者相比代谢相关脂肪性肝病（MASLD）的患病率，并评估激素过量在诱导MASLD中的作用。
单中心回顾性研究。
通过未增强腹部计算机断层扫描图像的肝/脾（L/S）比值评估肝脂肪变性（参考值<1.1），该队列包括41例无皮质醇共分泌的PA患者，其中20例为单侧（uPA），21例为双侧（BPA），50例为无功能肾上腺意外瘤（NF-AI），48例为轻度自主性皮质醇分泌（MACS），10例为肾上腺库欣综合征（CS）。
PA患者诊断时肝脂肪变性增加：PA患者的L/S比值低于NF-AI（1.1对1.25，p<0.001）和MACS（1.1对1.21，p=0.007），但与肾上腺CS相似（1.1对1.15，p=0.147）。PA患者经药物或手术治疗后L/S比值有所改善，肝脂肪变性减轻。PA患者的MASLD患病率高于MACS（49%对25%，p<0.05）和NF-AI（49%对14%，p<0.001），但与CS相似（49%对45%，p=0.61）。uPA患者的MASLD患病率高于BPA组，分别为71%（53%-89%）和25%（7%-43%）。
与MACS和NFAI相比，PA患者中MASLD的患病率增加（uPA高于BPA），且与肾上腺CS相似。
