FRI145 Prevalence Of Type 2 Diabetes Mellitus And Risk Factors For Its Development In Patients With Primary Aldosteronism
Year: 2023
Type: article
Study design: Observational Study
Abstract: Disclosure: M. Araujo-Castro: None. M. Paja Fano: None. M. González Boillos: None. B. Pla Peris: None. E. Pascual-Corrales: None. A. García Cano: None. P. Parra: None. P. Martín Rojas-Marcos: None. J. Ruiz-Sanchez: None. A. Vicente Delgado: None. E. Gómez Hoyos: None. R. Ferreira: None. I. García Sanz: None. M. Recasens Sala: None. R. Barahona San Millan: None. M. Picón César: None. P. Díaz Guardiola: None. J. García González: None. C.M. Perdomo: None. L. Manjón Miguélez: None. R. García Centeno: None. Á. Rebollo Román: None. P. Gracia Gimeno: None. C. Robles Lázaro: None. M. Morales-Ruiz: None. M. Calatayud Gutiérrez: None. S. Simone Andree Furio Collao: None. D. Meneses: None. M. Sampedro Nuñez: None. V. Escudero Quesada: None. E. Mena Ribas: None. A. Sanmartin Sánchez: None. C. Gonzalvo Diaz: None. C. Lamas: None. F. Hanzu: None. Purpose: To evaluate the prevalence of type 2 diabetes mellitus (T2DM) in patients with primary aldosteronism (PA) and the risk factors for its development. Methods: A retrospective multicenter study of PA patients in follow-up in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Adrenal venous sampling (AVS) was informative of laterality in 128 out of 226 patients and adrenalectomy was performed in 201 patients. Unilateral PA was defined as biochemical cure after adrenalectomy or as a lateralization index in AVS > 2 with ACTH or >3 without ACTH stimulation. Results: Overall, 649 patients with PA were included. Median age was 55.5 (range 27.3-81.6) years, 59.1% were female and 58.5% had hypokalemia at diagnosis. A total of 224 patients were classified as unilateral PA (142 based on biochemical cure after adrenalectomy and 82 based also on AVS results) and 49 as bilateral PA. At diagnosis, 21.2% (n=137) had T2DM and 25 of them had microvascular complications, being diabetic kidney disease the most common (n=19). We identified as risk factors of type 2 diabetes: male sex (OR 2.80 [1.81-4.34], P<0.001), older age (OR 1.05 [1.03-1.07], P<0.001), familiar history of T2DM (OR 4.64 [2.39-8.99]), P<0.001), dyslipidemia (OR 4.05 [2.67-6.14], P<0.001), cardiovascular (OR 1.30 [1.14-1.48], P<0.001) and cerebrovascular disease (OR 1.59 [0.92-2.74], P=0.003), sleep apnea syndrome (SAS) (OR 2.21 [1.34-3.63], P=0.003), higher BMI (OR 1.06 per unit [1.03-1.10], <0.001), hypertension duration (OR 1.04 per year [1.02-1.06], P<0.001) and the number of antihypertensive drugs (OR 1.50 [1.29-1.74], P<0.0001). In the multivariant analysis, all these variables were independent risk factors for T2DM except for SAS, hypertension duration, sex, and BMI. No association was observed with plasma aldosterone concentration, potassium levels, unilaterality of PA or other parameters. No significant differences in the evolution of the glycemic control (fasting plasma glucose and HBA1c) were observed between T2DM who underwent surgery and those medically treated (P>0.05). Conclusion: Type 2 diabetes affects about one quarter of patients with PA and risk factors for its development are common than to the general population. Medical and surgical treatment provide a similar benefit in terms of glucose control in patients with PA and T2DM. Presentation: Friday, June 16, 2023
Source: Journal of the Endocrine Society
Authors: Marta Araujo-Castro, Miguel Paja Fano, Marga González Boillos, Begoña Pla Peris, Eider Pascual-Corrales, Ana María García Cano, Paola Parra, Patricia Martín Rojas-Marcos, Jorge Gabriel Ruiz-Sanchez, Almudena Vicente Delgado, Emilia Gómez Hoyos, Rui Ferreira, Iñigo García Sanz, Mònica Recasens Sala, Rebeca Barahona San Millan, María José Picón César, Patricia Díaz Guardiola, Juan Jesús García González, Carolina M Perdomo, Laura Manjón Miguélez, Rogelio García Centeno, Ángel Rebollo Román, Paola Gracia Gimeno, Cristina Robles Lázaro, Manuel Morales-Ruiz, María Calatayud Gutiérrez, Simone Simone Andree Furio Collao, Diego Meneses, Miguel Antonio Sampedro Nuñez, Verónica Escudero Quesada, Elena Mena Ribas, Alicia Sanmartin Sánchez, Cesar Gonzalvo Diaz, Cristina Lamas, Felicia Hanzu
Institutions: Hospital Universitario Ramón y Cajal, Hospital de Basurto, Hospital Universitario La Paz, Hospital Universitario Fundación Jiménez Díaz, Hospital Universitario de Toledo, Hospital Clínico Universitario de Valladolid, Hospital Universitario de La Princesa, Institut Català de la Salut, Hospital Clínico Universitario Virgen de la Victoria, Hospital Universitario Infanta Sofía, Hospital Universitario Virgen Macarena, Clinica Universidad de Navarra, Hospital Universitario Central de Asturias, Hospital General Universitario Gregorio Marañón, Hospital Universitario Reina Sofía, Hospital Royo Villanova, Complejo Hospitalario de Salamanca, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Hospital Universitario 12 De Octubre, Hospital Universitario Son Espases, Complejo Hospitalario Universitario de Albacete
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,100
OpenAlex ID: W4387360855