Characteristics of glucolipid metabolism and analysis of related factors in patients with primary aldosteronism

Objective: To investigate the characteristics of glucolipid metabolism in patients with primary aldosteronism, and explore the related factors. Methods: Two hundred and ninety-nine patients with primary aldosteronism were classified into aldosterone producing adenoma group (APA group, n = 103), unilateral nodular adrenal hyperplasia group (UNAH group, n = 52) and bilateral adrenal hyperplasia group (BAH group, n = 144). Besides, another 100 patients with essential hypertension were served as control group. The clinical data of patients in each group were collected, and the parameters related to glucolipid metabolism were compared among groups. Meanwhile, correlation analysis was conducted between levels of serum and urine aldosterone and glucolipid metabolic parameters in patients with primary aldosteronism. Results: Compared with control group, the levels of post-prandial 30 min and 60 min blood glucose, serum triglyceride and total cholesterol in patients with primary aldosteronism were significantly lower (P < 0.01), and the level of serum high density lipoprotein was significantly higher (P < 0.01). The levels of post-prandial 60 min and 120 min blood glucose, post-prandial 60 min, 120 min and 180 min serum insulin and serum triglyceride in APA group were significantly lower than those in BAH group (P < 0.05), while the level of high density lipoprotein in APA group was significantly higher than that in BAH group (P < 0.05). Correlation analysis revealed that parameters of glucolipid metabolism were significantly negatively correlated with levels of 24 h urine aldosterone and serum baseline aldosterone in patients with primary aldosteronism (P < 0.05), and the abnormality of lipid metabolism was significantly positively correlated with duration of disease in patients with primary aldosteronism (P < 0.05). Conclusion: Abnormalities of glucose and lipid metabolism in patients with primary aldosteronism were less severe than those in patients with essential hypertension. Among the subtypes of primary aldosteronism, the abnormalities of glucose and lipid metabolism of BAH were more severe, and the abnormalities are related with the duration of disease.