Abstract

The prevalence of diabetes mellitus (DM) in primary aldosteronism (PA) patients is higher than essential hypertension patients and general population. Though both DM and PA play an important role in the progression of cardiovascular and cerebrovascular (CCV) diseases, the relationship between DM and these diseases in PA patients have not been evaluated.The aim of this study was to investigate whether DM was involved in the risk of CCV events and the progression of renal disorder in PA patients. This study was conducted as a part of the Japan Primary Aldosteronism Study/ Japan Rare Intractable Adrenal Diseases Study (JPAS/JRAS) study and retrospective cross-sectional analysis. The nationwide PA registry in Japan was established at 29 centers, including 15 university hospitals and 14 city hospitals. Patients, who were diagnosed PA between January 2006 and October 2016 and had available data of CCV events and DM, were enrolled (n=2,524). Logistic and liner-regression analysis for CCV events and renal parameters were performed. DM significantly increased the odds ratio of CCV events (OR 1.59, 95% CI: 1.05-2.41). DM also significantly increased the odds ratio of proteinuria (OR 2.25, 95% CI: 1.59-3.16) and had significant positive correlation with declines in eGFR (β=0.05, p=0.02). In conclusion, DM is an independent risk factor for CCV events and proteinuria in PA patients. We should pay attention to whether DM coexists with PA and treat both DM and PA to prevent the exacerbation of CCV diseases and kidney disease. (Supported by AMED grants No. JP17ek0109112/ JP19ek0109352; National Center for Global Health and Medicine, Japan (27-1402/ 30-1008)).

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