학술논문
Prevalence, risk factors and evolution of diabetes mellitus after treatment in primary aldosteronism. Results from the SPAIN-ALDO registry
Document Type
Original Paper
Author
Araujo-Castro, M.; Paja Fano, M.; Pla Peris, B.; González Boillos, M.; Pascual-Corrales, E.; García Cano, A. M.; Parra Ramírez, P.; Martín Rojas-Marcos, P.; Ruiz-Sanchez, J. G.; Vicente Delgado, A.; Gómez Hoyos, E.; Ferreira, R.; García Sanz, I.; Recasens Sala, M.; Barahona San Millan, R.; Picón César, M. J.; Díaz Guardiola, P.; Perdomo, C. M.; Manjón Miguélez, L.; García Centeno, R.; Percovich, J. C.; Rebollo Román, Á.; Gracia Gimeno, P.; Robles Lázaro, C.; Morales-Ruiz, M.; Calatayud Gutiérrez, M.; Furio Collao, S. A.; Meneses, D.; Sampedro Nuñez, M. A.; Escudero Quesada, V.; Mena Ribas, E.; Sanmartín Sánchez, A.; Gonzalvo Diaz, C.; Lamas, C.; Guerrero-Vázquez, R.; del Castillo Tous, M.; Serrano Gotarredona, J.; Michalopoulou Alevras, T.; Moya Mateo, E. M.; Hanzu, F. A.
Source
Journal of Endocrinological Investigation: Official Journal of Italian Society of Endocrinology (SIE). 46(11):2343-2352
Subject
Language
English
ISSN
1720-8386
Abstract
Purpose: To evaluate the prevalence, risk factors and evolution of diabetes mellitus (DM) after targeted treatment in patients with primary aldosteronism (PA).Methods: A retrospective multicenter study of PA patients in follow-up at 27 Spanish tertiary hospitals (SPAIN-ALDO Register).Results: Overall, 646 patients with PA were included. At diagnosis, 21.2% (n = 137) had DM and 67% of them had HbA1c levels < 7%. In multivariate analysis, family history of DM (OR 4.00 [1.68–9.53]), the coexistence of dyslipidemia (OR 3.57 [1.51–8.43]) and advanced age (OR 1.04 per year of increase [1.00–1.09]) were identified as independent predictive factors of DM. Diabetic patients were on beta blockers (46.7% (n = 64) vs. 27.5% (n = 140), P < 0.001) and diuretics (51.1% (n = 70) vs. 33.2% (n = 169), p < 0.001) more frequently than non-diabetics. After a median follow-up of 22 months [IQR 7.5–63.0], 6.9% of patients developed DM, with no difference between those undergoing adrenalectomy and those treated medically (HR 1.07 [0.49–2.36], p = 0.866). There was also no significant difference in the evolution of glycemic control between DM patients who underwent surgery and those medically treated (p > 0.05).Conclusion: DM affects about one quarter of patients with PA and the risk factors for its development are common to those of the general population. Medical and surgical treatment provides similar benefit in glycemic control in patients with PA and DM.