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Meta-Analysis
. 2022 Aug 31;22(1):217.
doi: 10.1186/s12902-022-01135-y.

The differences of serum lipid profiles between primary aldosteronism and essential hypertension: a meta-analysis and systematic review

Worapaka Manosroi  1 , Pitchaporn Phudphong  2 , Pichitchai Atthakomol  3   4 , Mattabhorn Phimphilai  2
Affiliations
Meta-Analysis

The differences of serum lipid profiles between primary aldosteronism and essential hypertension: a meta-analysis and systematic review

Worapaka Manosroi et al. BMC Endocr Disord. .

Abstract

Background: The data on lipid profile differences between primary aldosteronism (PA) and essential hypertension (EH) patients are inconsistent and inconclusive. Most studies reported lower levels of lipid profiles in PA than in EH. This meta-analysis aimed to explore differences in serum lipid profiles including triglyceride (TG), total cholesterol (TC), LDL and HDL levels in PA patients and EH patients.

Methods: A search of published studies was performed using PubMed, Embase and Scopus databases from their inception through August 2022. Thirty studies involving 11,175 patients were identified. Inclusion criteria included 1) observational studies which contained data on any of the lipid profiles of interest (TG, TC, LDL and HDL) which could be acquired from baseline data or the outcomes, 2) data which should be compared between adult PA and EH patients and 3) the use of appropriate methods to diagnose PA. Standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated to assess effect size by using STATA program version 15.0. Risk of bias was assessed by Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional, cohort and case-control studies.

Results: Levels of the lipid parameters TG (SMD - 0.16 mmol/L; 95%CI (- 0.25, - 0.07)), TC (SMD - 0.30 mmol/L; 95%CI (- 0.41, - 0.19)) and LDL (SMD - 0.17 mmol/L; 95%CI (- 0.27, - 0.08)) were significantly lower in PA than in EH patients. There was no statistically significant difference in HDL between PA and EH patients (SMD - 0.08 mmol/L; 96%CI (- 0.23,0.07)). High levels of heterogeneity for TG, TC, HDL and LDL were observed in all studies. Risk of bias among the studies was low to moderate.

Conclusion: Lower levels of TG, TC and LDL were observed in PA than in EH patients. Further study should be conducted to address the underlying mechanisms of lipid alteration in PA.

Keywords: Cholesterol; Essential hypertension; HDL; LDL; Lipid profiles; Primary aldosteronism; Triglycerides.

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Conflict of interest statement

Authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

Fig. 1
Fig. 1
Flowchart of study selection process
Fig. 2
Fig. 2
Forest plot of the mean difference of triglyceride (A), cholesterol (B), HDL (C) and LDL (D) levels between primary aldosteronism and essential hypertension patients
Fig. 3
Fig. 3
Forest plot of the sensitivity analysis presented by mean difference of triglyceride (A), cholesterol (B), HDL (C) and LDL (D) levels between primary aldosteronism and essential hypertension patients
See this image and copyright information in PMC

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