title: Worsening of lipid metabolism after successful treatment of primary aldosteronism.
abstract: Primary aldosteronism (PA) describes the most frequent cause of secondary arterial hypertension. Recently, deterioration of lipid metabolism after adrenalectomy (ADX) for aldosterone-producing adenoma (APA) has been described. We analysed longitudinal changes in lipid profiles in a large prospective cohort of PA patients. Data of 215 consecutive PA patients with APA (n = 144) or bilateral idiopathic adrenal hyperplasia (IHA, n = 71) were extracted from the database of the German Conn's Registry. Patients were investigated before and 1 year after successful treatment by ADX or by mineralocorticoid receptor antagonists (MRA). Glomerular filtration rate (GFR), fasting plasma glucose and components of lipid metabolism including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined at 8.00 after a 12-h fasting period. One year after initiation of treatment mean serum potassium levels and blood pressure normalized in the patients. HDL-C and TG developed inversely with decreasing HDL-C levels in patients with APA (p = .046) and IHA (p = .004) and increasing TG levels (APA p = .000; IHA p = .020). BMI remained unchanged and fasting plasma glucose improved in patients with APA (p = .004). Furthermore, there was a significant decrease of GFR in both subgroups at follow-up (p = .000). Changes in HDL-C and TG correlated with decrease in GFR in multivariate analysis (p = .024). Treatment of PA is associated with a deterioration of lipid parameters despite stable BMI and improved fasting plasma glucose and blood pressure. This effect can be explained by renal dysfunction following ADX or MRA therapy.
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Adolf
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Asbach
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany.
authors.forename: Anna Stephanie
authors.initials: AS
authors.lastname: Dietz
authors.affiliation: Medizinische Klinik I, Julius-Maximilians-Universität, Würzburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Lang
authors.affiliation: Medizinische Klinik I, Julius-Maximilians-Universität, Würzburg, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hahner
authors.affiliation: Endokrinologiepraxis in Charlottenburg, Berlin, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Quinkler
authors.affiliation: Klinik für Nephrologie, Heinrich Heine Universität, Düsseldorf, Germany.
authors.forename: Lars Christian
authors.initials: LC
authors.lastname: Rump
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Treitl
authors.affiliation: Klinik für Viszeral- und Endokrine Chirurgie, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Ladurner
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Beuschlein
authors.affiliation: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Ziemssenstr. 1, 80336, Munich, Germany. martin.reincke@med.uni-muenchen.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Reincke
mesh_terms: D000236:Adenoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D000315:Adrenalectomy; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006929:Hyperaldosteronism / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D050356:Lipid Metabolism / Q000187:drug effects / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D012042:Registries
chemical_list: D000451:Mineralocorticoid Receptor Antagonists
keywords: Aldosterone; Glomerular hyperfiltration; Lipid metabolism; Primary aldosteronism