Michio Otsuki    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor and Division head
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Obesity as a Key Factor Underlying Idiopathic Hyperaldosteronism
Journal	Formal name：The Journal of clinical endocrinology and metabolism Abbreviation：J Clin Endocrinol Metab ISSN code：0021972X/19457197
Domestic / Foregin	Foregin
Volume, Issue, Page	103(12),pp.4456-4464
Author and coauthor	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
Publication date	2018
Summary	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
Document No.	30165444