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. 2020 Mar;92(3):206-213.
doi: 10.1111/cen.14145. Epub 2020 Jan 19.

Unilateral primary aldosteronism as an independent risk factor for vertebral fracture

Maki Yokomoto-Umakoshi  1 , Ryuichi Sakamoto  1 , Hironobu Umakoshi  1 , Yayoi Matsuda  1 , Hiromi Nagata  1 , Tazuru Fukumoto  1 , Masatoshi Ogata  1 , Yoshihiro Ogawa  1 ; Q-AND-A study group
Affiliations

Unilateral primary aldosteronism as an independent risk factor for vertebral fracture

Maki Yokomoto-Umakoshi et al. Clin Endocrinol (Oxf). 2020 Mar.

Abstract

Context: Primary aldosteronism (PA) is known to increase vertebral fracture (VF), although the detailed mechanism remains to be elucidated. We hypothesized that the PA subtype is associated with VF.

Objective: To evaluate whether unilateral PA is associated with the prevalence of VF.

Design: This was a retrospective cross-sectional study in a single referral centre.

Patients: We identified 210 hypertensive patients whose clinical data were available for case-detection results. One hundred and fifty-two patients were diagnosed with PA using captopril challenge tests.

Measurements: We measured the prevalence of VF, according to PA subtype.

Results: One hundred thirteen patients with PA were subtype classified by adrenal vein sampling. Of these, 37 patients had unilateral PA, 76 patients had bilateral PA, 58 patients had non-PA; 39 patients with PA were not subtype-classified. Patients with PA had a higher prevalence of VF (29%, 44/152) than those with non-PA (12%, 7/58; P = .011). Moreover, unilateral PA had a higher prevalence of VF (46%, 17/37) than bilateral PA (20%, 15/76; P = .021). There was no significant difference in the prevalence of VF between bilateral PA and non-PA. Unilateral PA was an independent risk factor for VF after adjusting for age and sex (OR: 3.16, 95% confidence interval: 1.12-8.92; P = .017). Among patients with unilateral PA, serum cortisol concentrations after 1-mg dexamethasone suppression test were higher in those with VF (1.32 ± 0.67 g/dL) than those without (0.96 ± 0.33 g/dL; P = .048).

Conclusions: Unilateral PA is an independent risk factor for VF.

Keywords: osteoporosis; unilateral primary aldosteronism; vertebral fracture.

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References

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