The Prevalence Of Metabolic Syndrome In Patients With The Different Subtypes Of Primary Aldosteronism And Its Risk Factors

Objective:Metabolic syndrome(MetS)is a frequent clinical condition in hypertension patients,and is more frequently reported in primary aldosteronism(PA).PA has two main subtypes:unilateral PA and bilateral PA.So this study is aimed at investigating the prevalence of MetS and its components in patients with two different subtypes of PA.Methods:169 consecutive inpatients who had been diagnosed with PA in our department and subtyped by adrenal venous sampling(AVS),between January and December 2017,were enrolled.According to AVS results,there were 85 unilateral PA patients and 84bilateral PA patients.In addition,169 essential hypertension patients matched for sex and age(±3 year)were enrolled as a control group.We analyzed the prevalence of MetS and its components in patients with two different subtypes of PA and patients with essential hypertension,and explored the factors of MetS in patients with PA.Results:Patients with unilateral PA had higher concentrations of aldosterone and lower serum potassium than patients with bilateral PA.However,patients with bilateral PA had higher prevalence of MetS(79.76%vs.64.71%,P=0.029),obesity(40.48%vs.24.71%,P=0.029),dyslipidemia(72.62%vs.55.29%,P=0.019)and hyperglycemia(29.76%vs.16.47%,P=0.040)than those with unilateral PA.Meanwhile,bilateral PA had higher BMI(27.55±4.58 vs.25.57±3.28 kg/m~2,P=0.001),waist circumference(98.54±11.44 vs.93.32±10.64 cm,P=0.003)and fasting plasma glucose(4.98±1.16 vs.4.64±0.93 mmol/L,P=0.034).The logistic regression analysis also showed that bilateral PA was independently associated with MetS(OR,2.499;95%CI,1.179-5.298;P=0.017)and obesity(OR,2.020;95%CI,1.012-4.034;P=0.046)after adjustment for sex,age and duration of hypertension.Conclusions:Patients with bilateral PA have a higher prevalence of MetS than those with unilateral PA,despite unilateral PA patients exhibiting higher concentrations of aldosterone and lower serum potassium.