Elevated Myoglobin in Patients With Primary Aldosteronism: A Cross-Sectional Study.

Bing Kang,Linqiang Ma,Yi Yang,Shumin Yang,Fei-Fei Wu,Chuan Peng,Qifu Li,Mei Mei,Jinbo Hu,Kanran Wang,Ying Song

doi:10.3389/fendo.2022.799174

Abstract

ObjectivesPrimary aldosteronism (PA) is characterized by the autonomous excessive production of aldosterone in the adrenal cortex. Aldosterone is associated with damages to heart muscle and skeletal muscle. The purpose of this study was to evaluate serum levels of muscle injury markers and their associated factors in patients with primary aldosteronism.MethodsWe retrospectively enrolled subjects with PA and essential hypertension (EH) who had completed testing for serum high sensitivity troponin T (hs-TnT), creatine kinase isoenzyme MB (CK-MB) and myoglobin from the database of the Chongqing Primary Aldosteronism Study (CONPASS). Univariate and multivariate linear regression analyses were performed to analyze the influencing factors of myocardial injury markers.ResultsIn total, 278 patients with PA and 445 patients with EH were enrolled in this study. Compared with EH patients, serum concentrations of hs-TnT [7.0 (4.0–12.0) vs. 6.0 (3.0–11.0) ng/L; p=0.005] and myoglobin [24.2 (21.0–38.1) vs. 21.8 (21.0–31.9) μg/L; p=0.023] were significantly higher among PA patients, while no significant difference of CK-MB was found between two groups [1.4 (1.0–2.0) vs. 1.3 (0.9–1.9) μg/L; p=0.154]. Univariate linear regression analysis showed that myoglobin was negatively correlated with serum potassium (β=-0.31; p<0.01) and positively correlated with plasma aldosterone concentration (β=0.40; p<0.01) in the PA group, while no significant correlation was found between hs-TnT and biochemical parameters. After adjusting for multiple confounders, myoglobin was negatively correlated with serum potassium (β=-0.15; p<0.05) and positively correlated with plasma aldosterone concentration (β=0.34; p<0.01) in the PA group.ConclusionsThe serum level of myoglobin was significantly increased in PA patients, and myoglobin was independently correlated with plasma aldosterone concentration.

Highlights

Primary aldosteronism (PA) is characterized by the autonomous excessive production of aldosterone in the adrenal cortex, resulting in sodium retention, potassium excretion, increased blood volume, and a suppressed renin-angiotensin system [1]
Univariate linear regression analysis showed that myoglobin was negatively correlated with serum potassium (b=-0.31; p
The serum level of myoglobin was significantly increased in PA patients, and myoglobin was independently correlated with plasma aldosterone concentration

Summary

Introduction

Primary aldosteronism (PA) is characterized by the autonomous excessive production of aldosterone in the adrenal cortex, resulting in sodium retention, potassium excretion, increased blood volume, and a suppressed renin-angiotensin system [1]. Patients with PA have a higher risk of cardiovascular events, kidney damage and all-cause mortality than those with essential hypertension (EH) who are matched for age, sex, and blood pressure [6]. Excessive aldosterone concentrations promote the onset and progression of cardiovascular diseases through various mechanisms, such as chronic vascular fluid retention, endothelial dysfunction, target organ inflammation and fibrosis [7]. Previous studies have shown that CK-MB and myoglobin are mainly distributed in the myocardium and skeletal muscle, and increase after damage to the myocardium or skeletal muscle cells, and hs-TnT is significantly elevated in acute coronary syndrome, and reflects chronic myocardial injury or subclinical myocardial injury of unknown causes [10]. Previous study showed that aldosterone is associated with damages to heart and skeletal muscle cells [16–19], while very few studies have evaluated serum levels of muscle injury markers in PA patients

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