Endocrine Abstracts

Background: A few studies have shown that aldosterone has negative impact on metabolic parameters.

Objectives: The aim of the study was to evaluate metabolic parameters in patients with primary aldosteronism (PA) before and one year after adrenalectomy.

Methods: In this retrospective study, we examined 51 patients (median age 50 years, IQR 43–55; 55% male) who underwent adrenalectomy for PA between 2016 and 2022. Patients with diabetes mellitus, dyslipidemia, and autonomous cortisol secretion were excluded. We assessed differences in glucose (n=24), lipid profiles (n=32), body weight (n=47), and the defined daily dosage (DDD) of antihypertensives (n=51). Clinical remission of PA was defined according to PASO criteria.

Results: Complete clinical remission was attained by 45% of patients, while 51% achieved partial clinical remission, and 4% experienced no clinical remission. A year after surgery, there was a significant reduction in the median defined daily dosage (DDD) of antihypertensives compared to pre-surgery levels (4.5 vs 1.3, P<0.001). Similarly, the median fasting glucose level also showed marked improvement after surgery (5.1 mmol/l vs 4.9 mmol/l ; P=0.035). Conversely, no significant differences were observed in total cholesterol and triglyceride levels (P=0.754) and body weight (P=0.724) before and after surgery.

Conclusion: Adrenalectomy in patients with PA resulted in significant improvements in metabolic parameters, including reduced use of antihypertensive medications and improved fasting glucose levels one year after surgery. These results emphasise the potential metabolic benefits of adrenalectomy in the treatment of primary aldosteronism.