Sex-specific Association of Primary Aldosteronism With Visceral Adiposity.
Sex-specific Association of Primary Aldosteronism With Visceral Adiposity.
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DOI：
10.1210/jendso/bvac098
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发表时间：
2022-08-01
影响因子：
4.1
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原发性醛固酮增多症与肥胖之间的关联，尤其是其性别差异，仍不明确。
评估原发性醛固酮增多症各亚型与包括内脏脂肪组织在内的肥胖参数之间的关联以及性别差异。
在这项病例对照研究中，为每例原发性醛固酮增多症患者选取4名血压正常的对照者。采用多变量条件逻辑回归模型来评估每种原发性醛固酮增多症类型与肥胖指标之间的关联。我们使用随机森林来确定哪些内脏或皮下组织区域与疾病状态有更密切的关联。
研究对象包括42例醛固酮瘤患者（22名女性）和68例特发性醛固酮增多症患者（42名女性）。在多变量条件逻辑回归中，与匹配的对照组相比，醛固酮瘤仅在男性中与体重指数显著相关（比值比[OR][95%置信区间]，每增加2.89 kg/m²为4.62[1.98 - 10.80]），而在女性中不相关（OR[95%置信区间]，每增加3.93 kg/m²为1.09[0.69 - 1.72]）；然而，与匹配的对照组相比，特发性醛固酮增多症在男性（OR[95%置信区间]，每增加3.75 kg/m²为3.96[2.03 - 7.73]）和女性（OR[95%置信区间]，每增加3.85 kg/m²为2.65[1.77 - 3.96]）中均与体重指数相关。在随机森林中，内脏脂肪组织区域比皮下脂肪组织能更好地预测醛固酮瘤和特发性醛固酮增多症。
醛固酮瘤患者在男性中肥胖，但在女性中不肥胖。特发性醛固酮增多症患者在男性和女性中均肥胖。内脏脂肪组织可能在原发性醛固酮增多症的病理生理过程中起作用。
The association between primary aldosteronism and obesity, especially its sex difference, remains unknown. To assess the association for each subtype of primary aldosteronism with obesity parameters including visceral adipose tissue and differences between sexes. In this case-control study, 4 normotensive controls were selected for each case with primary aldosteronism. Multivariable conditional logistic regression models were used to estimate the association between each type of primary aldosteronism and obesity indicators. We used a random forest to identify which visceral or subcutaneous tissue areas had a closer association with disease status. The study subjects included 42 aldosterone-producing adenoma cases (22 women) and 68 idiopathic hyperaldosteronism cases (42 women). In multivariable conditional logistic regressions, aldosterone-producing adenoma was significantly associated with body mass index only in men (odds ratio [OR] [95% CI)], 4.62 [1.98-10.80] per 2.89 kg/m2) but not in women (OR [95% CI], 1.09 [0.69-1.72] per 3.93 kg/m2) compared with the matched controls, whereas idiopathic hyperaldosteronism was associated with body mass index in both men (OR [95% CI], 3.96 [2.03-7.73] per 3.75 kg/m2) and women (OR [95% CI], 2.65 [1.77-3.96] per 3.85 kg/m2) compared with the matched controls. In random forests, visceral adipose tissue areas were the better predictor of both aldosterone-producing adenoma and idiopathic hyperaldosteronism than subcutaneous adipose tissue. Aldosterone-producing adenoma cases were obese among men, but not among women. Idiopathic hyperaldosteronism cases were obese among both men and women. Visceral adipose tissue may contribute to the pathophysiology of primary aldosteronism.