Elevated prevalence of abnormal glucose metabolism in patients with primary aldosteronism: a meta-analysis.

OBJECTIVE: To conduct a meta-analysis of studies assessing abnormal glucose metabolism (AGM) prevalence among patients with primary aldosteronism (PA), calculating a combined pooled prevalence and summarizing metabolic parameters associated the pooled prevalence for comparative group.
METHOD: Four electronic databases (PubMed, EMBASE, Cochrane CENTRAL, and ISI-Web of Science) were systematically retrieved with no language and time restriction. Studies about elevated level of glucose metabolism in primary aldosteronism were included. RESULT: Data were available in 16 studies. The pooled analysis revealed that the prevalence of elevated glucose in PA was 22.41 % (95 % CI 16.77-28.05 %), the retrospectively calculated prevalence was 31.20 % (95 % CI 15.81-46.60 %) for impaired fasting glucose, 26.19 % (95 % CI 15.17-37.21 %) for impaired glucose tolerance, 15.22 % (95 % CI 9.93-20.51 %) for diabetes mellitus. Prevalence of AGM in PA was higher than that in essential hypertension (OR = 1.55, 95 % CI 1.01-2.36, p = 0.04). From comparative groups, patients with primary aldosteronism had a lower level of insulin sensitivity indicators in comparison with normal group (p < 0.01). On the other hand, insulin resistance which presented by HOMA index was stronger in PA group than in normal control group (WMD = 0.41, 95 % CI 0.17, 0.65; p = 0.001), whereas it was weaker than that in EH group (WMD = -0.37, 95 % CI -0.62, -0.13; p = 0.003).
CONCLUSION: There is a significant prevalence of elevated level of glucose metabolism in patients with PA. Awareness and treatment of this pre-diabetic or diabetic state are necessary.