Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Abstract

Context: The involvement of visceral fat in aldosterone secretion has not been reported in patients with primary aldosteronism (PA). Patients with PA are complicated by metabolic syndrome more frequently than those without PA. An excess of visceral fat has been hypothesized to cause an elevation of aldosterone secretion in patients with PA.

Objectives: To clarify the role of visceral fat in the pathophysiology of PA, we investigated the correlation between plasma aldosterone concentration (PAC) and visceral fat parameters in patients with PA.

Design: This retrospective observational study comprised 131 patients diagnosed with PA between April 2007 and April 2017 at Sapporo City General Hospital. We divided participants into two PA subtypes, aldosterone-producing adenoma (APA; n = 47) and idiopathic hyperaldosteronism (IHA, n = 84), utilizing adrenal venous sampling. We analyzed the correlations of PAC with visceral fat percentage (VF%), visceral fat area (VFA), and subcutaneous fat area, by evaluating computed tomography studies in each subtype group.

Results: Patients with IHA showed a positive correlation of PAC with VF% (r = 0.377, P < 0.001) and VFA (r = 0.443, P < 0.001). The correlation was not evident in patients with APA.

Conclusions: This study revealed a relationship between visceral adipose tissue and aldosterone production only in patients with IHA.

Keywords: hypertension; idiopathic hyperaldosteronism; obesity; primary aldosteronism; visceral adipose tissue.

Figure 1.

Flowchart of patients with each PA subtype. SI, selectivity index.

Figure 2.

Comparison of VF% between APA and IHA for each sex. A comparison of VF% between patients with APA and IHA for each sex were presented. *P < 0.05.

Figure 3.

Correlation between PAC and each factor in patients with IHA. Correlation of PAC with (A) VF%, (B) VFA, (C) SCFA, (D) BMI, and (E) waist circumference in patients with IHA.