Gregor Hanslik1, Henri Wallaschofski1, Anna Dietz1, Anna Riester1, Martin Reincke1, Bruno Allolio1, Katharina Lang1, Ivo Quack1, Lars C Rump1, Holger S Willenberg1, Felix Beuschlein1, Marcus Quinkler2, Anke Hannemann1. 1. Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyInstitute of Clinical Chemistry and Laboratory MedicineUniversity Medicine Greifswald, Greifswald, GermanyMedizinische Klinik und Poliklinik IVEndocrinology and Metabolism, University Hospital Munich, Munich, GermanyEndocrinology and Diabetes UnitDepartment of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, GermanyDepartment of NephrologyMedical Faculty, Heinrich-Heine University Duesseldorf, Duesseldorf, GermanyDivision of Endocrinology and MetabolismRostock University Medical Center, Rostock, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany. 2. Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyInstitute of Clinical Chemistry and Laboratory MedicineUniversity Medicine Greifswald, Greifswald, GermanyMedizinische Klinik und Poliklinik IVEndocrinology and Metabolism, University Hospital Munich, Munich, GermanyEndocrinology and Diabetes UnitDepartment of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, GermanyDepartment of NephrologyMedical Faculty, Heinrich-Heine University Duesseldorf, Duesseldorf, GermanyDivision of Endocrinology and MetabolismRostock University Medical Center, Rostock, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyInstitute of Clinical Chemistry and Laboratory MedicineUniversity Medicine Greifswald, Greifswald, GermanyMedizinische Klinik und Poliklinik IVEndocrinology and Metabolism, University Hospital Munich, Munich, GermanyEndocrinology and Diabetes UnitDepartment of Internal Medicine I, University Hospital of Wuerzburg, Wuerzburg, GermanyDepartment of NephrologyMedical Faculty, Heinrich-Heine University Duesseldorf, Duesseldorf, GermanyDivision of Endocrinology and MetabolismRostock University Medical Center, Rostock, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany marcus.quinkler@t-online.de.
Abstract
DESIGN: Abnormalities in glucose homeostasis have been described in patients with primary aldosteronism (PA) but most studies show inconsistent results. Therefore, we aimed to compare the prevalence of type 2 diabetes mellitus and metabolic syndrome (MetS) in newly diagnosed PA patients to a matched control cohort of the background population. METHODS: In total, 305 PA patients of the prospective German Conn's Registry were compared to the population-based Study of Health In Pomerania (SHIP1; n=2454). A 1:1 match regarding sex, age, and BMI resulted in 269 matched pairs regarding type 2 diabetes and 183 matched pairs regarding MetS. Of the total, 153 PA patients underwent oral glucose tolerance testing (OGTT) at diagnosis and 38 PA patients were reevaluated at follow-up. RESULTS: Type 2 diabetes and MetS were significantly more frequent in PA patients than in the control population (17.2% vs 10.4%, P=0.03; 56.8% vs 44.8%, P=0.02 respectively). Also, HbA1c levels were higher in PA patients than in controls (P<0.01). Of the total, 35.3% of non-diabetic PA patients showed an abnormal OGTT (¼ newly diagnosed type 2 diabetes and ¾ impaired glucose tolerance). PA patients with an abnormal OGTT at baseline presented with significantly improved 2 h OGTT glucose (P=0.01) at follow-up. We detected a negative correlation between 2 h OGTT glucose levels and serum potassium (P<0.01). CONCLUSIONS: Type 2 diabetes and MetS are more prevalent in patients with PA than in controls matched for sex, age, BMI, and blood pressure. This may explain in part the increased cardiovascular disease morbidity and mortality in PA patients.
DESIGN:Abnormalities in glucose homeostasis have been described in patients with primary aldosteronism (PA) but most studies show inconsistent results. Therefore, we aimed to compare the prevalence of type 2 diabetes mellitus and metabolic syndrome (MetS) in newly diagnosed PApatients to a matched control cohort of the background population. METHODS: In total, 305 PApatients of the prospective German Conn's Registry were compared to the population-based Study of Health In Pomerania (SHIP1; n=2454). A 1:1 match regarding sex, age, and BMI resulted in 269 matched pairs regarding type 2 diabetes and 183 matched pairs regarding MetS. Of the total, 153 PApatients underwent oral glucose tolerance testing (OGTT) at diagnosis and 38 PApatients were reevaluated at follow-up. RESULTS:Type 2 diabetes and MetS were significantly more frequent in PApatients than in the control population (17.2% vs 10.4%, P=0.03; 56.8% vs 44.8%, P=0.02 respectively). Also, HbA1c levels were higher in PApatients than in controls (P<0.01). Of the total, 35.3% of non-diabetic PApatients showed an abnormal OGTT (¼ newly diagnosed type 2 diabetes and ¾ impaired glucose tolerance). PApatients with an abnormal OGTT at baseline presented with significantly improved 2 h OGTT glucose (P=0.01) at follow-up. We detected a negative correlation between 2 h OGTT glucose levels and serum potassium (P<0.01). CONCLUSIONS:Type 2 diabetes and MetS are more prevalent in patients with PA than in controls matched for sex, age, BMI, and blood pressure. This may explain in part the increased cardiovascular disease morbidity and mortality in PApatients.
Authors: Christian Adolf; Evelyn Asbach; Anna Stephanie Dietz; Katharina Lang; Stefanie Hahner; Marcus Quinkler; Lars Christian Rump; Martin Bidlingmaier; Marcus Treitl; Roland Ladurner; Felix Beuschlein; Martin Reincke Journal: Endocrine Date: 2016-05-14 Impact factor: 3.633
Authors: Thomas G Papathomas; Na Sun; Vasileios Chortis; Angela E Taylor; Wiebke Arlt; Susan Richter; Graeme Eisenhofer; Gerard Ruiz-Babot; Leonardo Guasti; Axel Karl Walch Journal: Histochem Cell Biol Date: 2019-02-06 Impact factor: 4.304