オオツキ　ミチオ   Michio Otsuki   大月　道夫    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Obesity as a Key Factor Underlying Idiopathic Hyperaldosteronism
掲載誌名	正式名：The Journal of clinical endocrinology and metabolism 略　 称：J Clin Endocrinol Metab ISSNコード：0021972X/19457197
掲載区分	国外
巻・号・頁	103(12),pp.4456-4464
著者・共著者	Ohno, Y. Sone, M. Inagaki, N. Yamasaki, T. Ogawa, O. Takeda, Y. Kurihara, I. Umakoshi, H. Ichijo, T. Katabami, T. Wada, N. Ogawa, Y. Yoshimoto, T. Kawashima, J. Watanabe, M. Matsuda, Y. Kobayashi, H. Shibata, H. Miyauchi, S. Kamemura, K. Fukuoka, T. Yamamoto, K. Otsuki, M. Suzuki, T. Naruse, M. Jpas Study Group
発行年月	2018
概要	Context: Recently, the relationship between primary aldosteronism (PA) and various metabolic disorders, including obesity, diabetes mellitus, and dyslipidemia, has been discussed. However, in PA, aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) have different etiologies. Objective: Our objectives were to clarify differences in obesity and metabolic disorders between APA and IHA and to gain insight in the pathogenesis of IHA. Design, Setting, and Participants: This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter Japan Primary Aldosteronism Study. For comparative analysis, data were also collected from 274 patients with essential hypertension (EHT). Main Outcome Measures: We compared prevalences of obesity and metabolic disorders between patients with APA and patients with IHA. Comparisons with sex-, age-, and blood pressure-matched patients with EHT were also performed. Correlations between metabolic parameters and plasma aldosterone concentrations (PACs) in each subtype were analyzed. Results: Analysis of 516 patients with APA and 1015 patients with IHA revealed PACs were significantly higher in patients with APA than patients with IHA. By contrast, after we adjusted for clinical backgrounds, the prevalence of obesity was significantly higher in patients with IHA than in patients with APA or EHT. Although the prevalences of diabetes mellitus and dyslipidemia did not significantly differ between patients with IHA and patients with APA, triglyceride and HbA1c were significantly higher in patients with IHA than in patients with APA. There was no significant correlation between metabolic parameters and PACs in either subtype. Conclusions: Patients with IHA tend to be obese despite lower PACs than in patients with APA. The present results suggest that obesity-related factors contribute to the pathogenesis of IHA.
DOI	10.1210/jc.2018-00866
文献番号	30165444