May 18, 2017
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Primary aldosteronism incidence low in type 2 diabetes

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The prevalence of primary aldosteronism among adults with type 2 diabetes is relatively low, but those with primary aldosteronism have higher systolic blood pressure and lower potassium levels than those without adrenal dysfunction, according to published findings.

Perspective from

“We did not find any strong indications in this cross-sectional study that aldosterone levels or aldosterone/renin ratio are any strong risk factors for diabetic complications, but it cannot be excluded that some associations may exist that could potentially be detected in a long-time prospective study. ... Hypertension and hypokalemia were related to primary aldosteronism in this unselected cohort of persons with type 2 diabetes,” Marcus Lind, MD, PhD, of the Diabetes Outpatient Clinic at Uddevalla Hospital in Sweden, told Endocrine Today.

Lind and colleagues evaluated data from 578 adults (mean age, 65.8 years; 38.7% women) with type 2 diabetes (mean diabetes duration, 10 years) to determine the prevalence of primary aldosteronism among them.

Overall, 27 participants who were taking mineralocorticoid receptor agonists and potassium-sparing diuretics were excluded.

Five participants had confirmed primary aldosteronism, four had bilateral disease and one had unilateral disease after adrenal venous sampling. All participants with primary aldosteronism were men and were taking one or more antihypertensive medications.

Compared with participants without primary aldosteronism, participants with primary aldosteronism had higher systolic BP (P = .032) and lower potassium levels (P = .027). The number of BP medications, diabetes duration, metabolic control, BMI or daily insulin needs did not differ between participants with and without primary aldosteronism.

“[The findings] do not imply that general screening may be meaningful regarding primary aldosteronism in persons with type 2 diabetes. ... One should be alert for considering screening in patients with hypertension, advanced treatment for hypertension or hyperkalemia,” Lind said. “Aldosterone levels or aldosterone/renin ratio should not be used as an indicator for risk of diabetic complications in persons with type 2 diabetes based on our findings.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.