論文

査読有り 国際誌
2019年5月

High Prevalence of Diabetes in Patients With Primary Aldosteronism (PA) Associated With Subclinical Hypercortisolism and Prediabetes More Prevalent in Bilateral Than Unilateral PA: A Large, Multicenter Cohort Study in Japan.

Diabetes care
  • Yuko Akehi
  • ,
  • Toshihiko Yanase
  • ,
  • Ryoko Motonaga
  • ,
  • Hironobu Umakoshi
  • ,
  • Mika Tsuiki
  • ,
  • Yoshiyu Takeda
  • ,
  • Takashi Yoneda
  • ,
  • Isao Kurihara
  • ,
  • Hiroshi Itoh
  • ,
  • Takuyuki Katabami
  • ,
  • Takamasa Ichijo
  • ,
  • Norio Wada
  • ,
  • Yui Shibayama
  • ,
  • Takanobu Yoshimoto
  • ,
  • Kenji Ashida
  • ,
  • Yoshihiro Ogawa
  • ,
  • Junji Kawashima
  • ,
  • Masakatsu Sone
  • ,
  • Nobuya Inagaki
  • ,
  • Katsutoshi Takahashi
  • ,
  • Megumi Fujita
  • ,
  • Minemori Watanabe
  • ,
  • Yuichi Matsuda
  • ,
  • Hiroki Kobayashi
  • ,
  • Hirotaka Shibata
  • ,
  • Kohei Kamemura
  • ,
  • Michio Otsuki
  • ,
  • Yuichi Fujii
  • ,
  • Koichi Yamamoto
  • ,
  • Atsushi Ogo
  • ,
  • Shintaro Okamura
  • ,
  • Shozo Miyauchi
  • ,
  • Tomikazu Fukuoka
  • ,
  • Shoichiro Izawa
  • ,
  • Shigeatsu Hashimoto
  • ,
  • Masanobu Yamada
  • ,
  • Yuichiro Yoshikawa
  • ,
  • Tatsuya Kai
  • ,
  • Tomoko Suzuki
  • ,
  • Takashi Kawamura
  • ,
  • Mitsuhide Naruse

42
5
開始ページ
938
終了ページ
945
記述言語
英語
掲載種別
DOI
10.2337/dc18-1293

OBJECTIVE: To investigate the prevalence and causes of diabetes in patients with primary aldosteronism (PA) in a multi-institutional cohort study in Japan. RESEARCH DESIGN AND METHODS: The prevalence of diabetes was determined in 2,210 patients with PA (diagnosed or glycated hemoglobin [HbA1c] ≥6.5% [≥48 mmol/mol]; NGSP) and compared with that of the Japanese general population according to age and sex. In 1,386 patients with PA and clear laterality (unilateral or bilateral), the effects of plasma aldosterone concentration (PAC), hypokalemia (<3.5 mEq/L), suspected subclinical hypercortisolism (SH; serum cortisol ≥1.8 µg/dL after 1-mg dexamethasone suppression test), and PA laterality on the prevalence of diabetes or prediabetes (5.7% ≤ HbA1c <6.5% [39 mmol/mol ≤ HbA1c <48 mmol/mol]) were examined. RESULTS: Of the 2,210 patients with PA, 477 (21.6%) had diabetes. This prevalence is higher than that in the general population (12.1%) or in 10-year cohorts aged 30-69 years. Logistic regression or χ2 test revealed a significant contribution of suspected SH to diabetes. Despite more active PA profiles (e.g., higher PAC and lower potassium concentrations) in unilateral than bilateral PA, BMI and HbA1c values were significantly higher in bilateral PA. PA laterality had no effect on the prevalence of diabetes; however, the prevalence of prediabetes was significantly higher in bilateral than unilateral PA. CONCLUSIONS: Individuals with PA have a high prevalence of diabetes, which is associated mainly with SH. The prevalence of prediabetes is greater for bilateral than unilateral PA, suggesting a unique metabolic cause of bilateral PA.

リンク情報
DOI
https://doi.org/10.2337/dc18-1293
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31010944