The Relationship Of Aldosterone, Insulin Resistance And Lipid Profile In Obese And Overweight Patients

Due to the continuous improvement of living standards, the incidence of obesity and overweight are increasing in recent years. Obesity and overweight often company with multiple complications,such as insulin resistance and abnormal plasma lipid profile, hypertension, type 2 diabetes, eventually lead to the increase of the incidence of cardiovascular disease and mortality.Some researches have shown that excessive aldosterone leads to insulin resistance, insulin resistance has interaction with lipid metabolism, but the relationship between aldosterone and lipid metabolism has not been clear.Therefore, the purpose of this study is to explore the insulin resistance and lipid profile and their relationship with aldosterone in obesity and overweight.Collected patients with obesity and overweight in the department of endocrinology of Peking Union Medical College from January 2002 to December 2015, there were 42 patients in obesity and overweight, including 22 cases of male, 20 cases of female, average age was( 42.94±11.49) year, the average BMI was( 29.75±4.01)Kg/m2.Selecting 44 patients of primary aldosteronism, including 25 cases of male, 19 cases of female, average age was(47.48±9.63)year, the average BMI was(28.41±3.25)Kg/m2.There was no obvious difference on age?sex and BMI between the two groups.Collected their clinically data(such as height, weight, systolic blood pressure, diastolic blood pressure and so on)and biochemical data(such as lipid profile, oral glucose tolerance test, the renin-angiotensin-aldosterone system and so on).The result was triglycerides(TC) ? low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) in obese and overweight group were significantly higher than those in primary aldosteronism group(P<0.05), TC?LDL-C and HDL-C in simple obese group were significantly higher than those in primary aldosteronism with obesity group(P<0.05), LDL-C in simple obese group is significantly higher than simple overweight group(P<0.05), the level of HDL-C in the primary aldosteronism with overweight group is significantly higher than the primary aldosteronism with obesity(P < 0.05),HDL-C in normotensive obesity group is significantly higher than primary aldosteronism group(P<0.05); while the fasting insulin(FINS) ? postprandial serum insulin(PINS)?homoeostasis model assessment index(HOMA-IR) and modified beta cell function index(MBCI) in primary aldosteronism group is significantly higher than those in simple obese and overweight group(P<0.05), FINS ? HOMA-IR and MBCI in overweight of primary aldosteronism is significantly higher than simple overweight group(P<0.05),FINS?HOMA-IR and MBCI in primary aldosteronism with obesity group was significantly higher than those in simple obese group(P<0.05),FINS?3hFINS?HOMA-IR and MBCI in primary aldosteronism group is significantly higher than those in normotensive obesity group;the incidence of metabolic syndrome of the primary aldosteronism group was obviously higher than simple obese and overweight group(P<0.05) and the incidence of metabolic syndrome in simple obese group was higher than simple overweight group(P<0.05); HOMA-IR accompanies with TG?BMI?MBCI and insulin area under curve(INSAUC) in positive correlation in simple obese and overweight group,HOMA-IR accompanies with BMI?TC?MBCI? INSAUC and glucose area under curve(GLuAUC) in positive correlation(P<0.05) in primary aldosteronism group.Therefore, the insulin resistance is more serious in primary aldosteronism group than in simple obese and overweight group,while HDL-C?LDL-C and TC is lower than obese and overweight group. High aldosterone levels can increase insulin resistance and decrease HDL-C?LDL-C and TC, but the mechanism of those still needs further research.