Abstract
PurposeThis study aimed to determine the relationships among gut microbiota, primary aldosteronism (PA), and related metabolic disorders.MethodsThe study enrolled 13 PA patients, 26 sex-matched primary hypertension patients, and 26 sex-matched healthy controls. Demographic and clinical characteristics such as age, body mass index (BMI), blood aldosterone–renin ratio, blood potassium, blood glucose, blood lipid parameters, and history of diabetes mellitus (DM) were compared between the three groups. The gut microbiota of each participant was examined by 16S rRNA gene sequencing. Spearman correlation analysis was performed to demonstrate the relationship between gut microbiota and clinical characteristics.ResultsBMI and the percentage of DM in PA patients were higher than those in healthy controls (p < 0.05), but not higher than those in primary hypertension patients (p > 0.05). The gut microbiota of healthy controls and primary hypertension patients had a higher alpha diversity level than that of PA patients. PA patients had fewer short-chain fatty acid (SCFA)-producing genera (Prevotella, Blautia, Coprococcus, Anaerostipes, and Ruminococcus) and more inflammation-associated genera (Megamonas, Sutterella, and Streptococcus) than healthy controls (p < 0.05). The gut microbiota of PA patients was more inclined to encode microbial pathways involved in sugar metabolism, such as starch and sucrose metabolism and fructose and mannose metabolism. Blood potassium was negatively correlated with the relative abundance of Romboutsia (R = −0.364, q = 0.023). Diastolic blood pressure (DBP) was positively correlated with Romboutsia (R = 0.386, q = 0.015). Systolic blood pressure (SBP) was negatively correlated with Blautia (R = −0.349, q = 0.030).ConclusionsThe alteration of gut microbiota in PA patients, especially bacteria and pathways involved in inflammation, SCFAs, and sugar metabolism, may be associated with chronic metabolic disorders.
Highlights
Primary aldosteronism (PA) is the most common cause of secondary hypertension [1]
The gut microbiota of PA patients was more inclined to encode microbial pathways involved in sugar metabolism, such as starch and sucrose metabolism and fructose and mannose metabolism
The alteration of gut microbiota in PA patients, especially bacteria and pathways involved in inflammation, short-chain fatty acid (SCFA), and sugar metabolism, may be associated with chronic metabolic disorders
Summary
Primary aldosteronism (PA) is the most common cause of secondary hypertension [1]. PA is frequently poorly diagnosed and treated, leading to aldosterone-specific morbidity and mortality. Many studies have shown that the gut microbiota and its metabolites are involved in some metabolic diseases, such as metabolic syndrome, DM, and obesity [5,6,7,8]. Since the reasons for high prevalence of metabolic diseases in PA patients have not been well described, it will be interesting to explore the interaction between PA-induced metabolic disorders and independent microbial characteristics. To address this problem, we conducted a case–control study with 65 participants in which we analyzed gut microbiota to establish the intestinal microbial profiles of PA patients. We aimed to determine the relationship between gut microbiota, PA, and related metabolic diseases
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