Abstract
Background: Primary aldosteronism (PA) has been recently associated with an unfavourable cardiometabolic profile. Aldosterone has been also suggested to interact with the adipose tissue. However, whether pro and anti-inflammatory adipokines levels can vary in presence of elevated aldosterone levels, such as in PA, is unknown. Aim: We evaluated the circulating levels of plasma resistin, leptin and adiponectin, and the prevalence of metabolic syndrome (MS) in subjects with PA. Materials and Methods: 75 subjects with established diagnosis of PA and 232 consecutive individuals with known or suspected hypertension were enrolled in this study. Prevalence of MS was estimated. Blood, urinary, anthropometrics, 24-hours ambulatory blood pressure monitoring (ABPM) and echocardiographic parameters were also obtained. Results: Among the 75 PA subjects, 37 patients were affected by APA (aldosterone producing adenoma) and 38 by IHA (idiopathic hyperplasia aldosteronism); 40 subjects were affected by EH (essential hypertension) and MS (EH+MS); 152 subjects were affected by EH without MS (EH-MS); 40 subjects were normotensive (NT). Subjects with PA had the highest plasma resistin levels among the four groups (p < 0.01). Plasma resistin concentration was significantly higher in PA subjects when compared to EH+SM individuals (p < 0.01) and EH-SM subjects (p < 0.01). PA+SM showed significantly higher leptin levels than EH+SM subjects (p < 0.01). Plasma adiponectin concentration in PA subjects was lower when compared to NT and EH-SM subjects (p < 0.01). The prevalence of MS was higher in PA subjects than in those with EH (25.4% vs 20.3%). Hyperglycemia and low HDL prevalence was significantly higher in subjects with PA than in EH+MS subjects. Conclusions: Our data show that PA subjects independently of body fatness and age, have significantly: higher circulating resistin and leptin levels and higher rate of metabolic syndrome than individuals with essential hypertension and combined metabolic syndrome.
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