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Prevalence of primary aldosteronism among patients with type 2 diabetes.

Journal article
Authors Mauro Tancredi
Gudmundur Johannsson
Björn Eliasson
Robert Eggertsen
Ulf Lindblad
S Dahlqvist
Henrik Imberg
Marcus Lind
Published in Clinical endocrinology
Volume 87
Issue 3
Pages 233–241
ISSN 1365-2265
Publication year 2017
Published at Department of Mathematical Sciences
Institute of Medicine, School of Public Health and Community Medicine
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 233–241
Language en
Links dx.doi.org/10.1111/cen.13370
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Health Sciences, Clinical Medicine

Abstract

Diabetes and hypertension coexist in 40-60% of individuals with type 2 diabetes. The coexistence of this two conditions is associated with increased risk of retinopathy, nephropathy and cardiovascular disease.To investigate the prevalence of primary aldosteronism (PA) in a general cohort of persons with type 2 diabetes.Cross-sectional study involving 6 diabetes outpatient clinics in Sweden.Were enrolled individuals with type 2 diabetes between February 2008 and December 2013.Plasma aldosterone concentrations (PAC pmol/L) and direct renin concentrations (DRC mIU/L) were measured. Patients with increased aldosterone renin ratios (ARR) >65 were further evaluated for PA.Of 578 consecutively screened patients with type 2 diabetes, 27 were treated with mineralocorticoid receptor antagonists (MRA) and potassium-sparing diuretics not further evaluated. Among the remaining 551 patients, 38 had increased ARR, including 22 who were clinically indicated for PA tests and 16 who were not further evaluated due to severe comorbidities and old age. There were 5 (0.93%) patients with confirmed PA after computerized tomography and adrenal venous sampling. Patients with PA had higher systolic blood pressure (p= 0.032) and lower potassium levels (p=0.027) than those without PA. No significant association was found between plasma aldosterone and diabetic complications.The prevalence of PA in an unselected cohort of patients with type 2 diabetes is relatively low, and measures of plasma aldosterone are not strong risk factors for micro- and macrovascular diabetic complications. This article is protected by copyright. All rights reserved.

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