Association of visceral adiposity and clinical outcome among patients with aldosterone producing adenoma

Leay Kiaw Er, Meng Chun Lin, Yao Chou Tsai, Jong Kai Hsiao, Chung Yi Yang, Chin Chen Chang, Kang Yung Peng, Jeff S. Chueh, Vin Cent Wu

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction Primary aldosteronism (PA) is a common form of secondary hypertension that has significant cardiovascular events and increased prevalence of metabolic syndrome and diabetics. Although plasma aldosterone concentration is positively correlated with visceral fat area (VFA) in non-PA individuals, the role of visceral adiposity associated with clinical success after surgery is not known. Research design and methods We analyzed patients who underwent adrenalectomy for aldosterone-producing adenoma (APA) at the Taiwan PA Investigator group. VFA was calculated from the abdominal CT scan at APA diagnosis, and all patients received adrenalectomy. Results The study involved 100 consecutive patients with APA (42 males; mean age 49.3 years) matched with 41 essential hypertension (EH) patients. Patients with APA had smaller VFA (p=0.010) than their EH counterparts. Multiple linear regression analysis revealed that the duration of hypertension (p=0.007), but not plasma aldosterone, was negatively correlated with VFA in patients with APA. Logistic regression analysis showed that log VFA (OR=0.065, p<0.001) and duration of hypertension before PA diagnosis (OR=0.919, p=0.011) can predict complete clinical success after adrenalectomy. Multifactor-adjusted generalized additive model demonstrated that log VFA <9.2 was associated with complete cure of hypertension. Furthermore, VFA was increased at 6 months after adrenalectomy (p=0.045). Conclusions Patients with APA had smaller VFA than their EH counterparts, and VFA increased after adrenalectomy. Clinical complete cure of hypertension after surgery was associated with smaller VFA and shorter duration of hypertension at PA diagnosis, suggesting a potential interplay of visceral adiposity and aldosterone of the patients with APA.

Original languageEnglish
Article numbere001153
JournalBMJ Open Diabetes Research and Care
Volume8
Issue number1
DOIs
Publication statusPublished - Jul 26 2020

Keywords

  • adipocyte
  • adipocyte secretion
  • adipocytes - metabolism
  • adipose tissue

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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