Metabolic syndrome among patients with primary aldosteronism: a common feature?
G Giacchetti, V Ronconi, F Turchi, L Agostinelli, S Rilli & M Boscaro
In the light of recent data reporting a high rate of cardiovascular events in Primary Aldosteronism (PA) we investigated whether the Metabolic Syndrome (MS) represents a common feature in patients with PA. A cohort of 86 patients, mean age 51±12 yr was analysed: 59 patients (26 females and 39 males) with idiopathic hyperaldosteronism (IHA) and 27 patients (13 females and 14 males) with aldosterone producing adenoma (APA). Anthropometric parameters (height, weight, waist circumference), lipid profile (total cholesterol HDL cholesterol, tryglicerides) and glucose profile (fasting plasma glucose and insulin) were evaluated in all subjects. The MS was defined according to ATP III criteria, requiring the presence of at least three of the following factors: hypertension (Ht), obesity (O), high tryglicerides levels (T), low HDL cholesterol levels (C), high fasting plasma glucose (G). Thirty seven patients with PA fulfilled ATP III criteria with an overall prevalence of the MS of 43%: 8 patients with APA (30%) and 29 patients with IHA (49%). Considering the distribution within gender, 24 male patients (51%) had MS compared to 13 female patients (33%). No differences were observed between male/female distribution in APA and IHA (5/3 and 19/10, respectively).Considering the distribution of three or more factors:
Gender analysis showed that while female patients display more frequently obesity, male patients have more often alterations of the lipid and glucose profiles. Our data show that the prevalence of the MS in PA patients is about double than in the age-matched Italian population. Moreover the MS is more frequent in IHA patients than in APA, underlying that this variant of PA is more similar to essential hypertension. Finally, the presence of more than 3 ATP III factors in many PA patients underline that this secondary form of hypertension is not so benign and is strongly associated with metabolic alterations that may be involved in the development of cardiovascular events.