Scientific publications
Prevalence, risk factors and evolution of diabetes mellitus after treatment in primary aldosteronism. Results from the SPAIN-ALDO registry
M Araujo-Castro 1 2 3 , M Paja Fano 4 5 , B Pla Peris 6 , M González Boillos 6 , E Pascual-Corrales 7 8 , A M García Cano 9 , P Parra Ramírez 10 , P Martín Rojas-Marcos 10 , J G Ruiz-Sanchez 11 , A Vicente Delgado 12 , E Gómez Hoyos 13 , R Ferreira 14 , I García Sanz 15 , M Recasens Sala 16 , R Barahona San Millan 16 , M J Picón César 17 18 , P Díaz Guardiola 19 , C M Perdomo 20 , L Manjón Miguélez 21 22 , R García Centeno 23 , J C Percovich 23 , Á Rebollo Román 24 , P Gracia Gimeno 25 , C Robles Lázaro 26 , M Morales-Ruiz 27 , M Calatayud Gutiérrez 28 , S A Furio Collao 28 , D Meneses 11 , M A Sampedro Nuñez 29 , V Escudero Quesada 30 , E Mena Ribas 31 , A Sanmartín Sánchez 31 , C Gonzalvo Diaz 32 , C Lamas 32 , R Guerrero-Vázquez 33 , M Del Castillo Tous 33 , J Serrano Gotarredona 34 , T Michalopoulou Alevras 35 , E M Moya Mateo 36 , F A Hanzu 37
Purpose: To evaluate the prevalence, risk factors and evolution of diabetes mellitus (DM) after targeted treatment in patients with primary aldosteronism (PA).
Methods: A retrospective multicenter study of PA patients in follow-up at 27 Spanish tertiary hospitals (SPAIN-ALDO Register).
Results: Overall, 646 patients with PA were included. At diagnosis, 21.2% (n = 137) had DM and 67% of them had HbA1c levels < 7%. In multivariate analysis, family history of DM (OR 4.00 [1.68-9.53]), the coexistence of dyslipidemia (OR 3.57 [1.51-8.43]) and advanced age (OR 1.04 per year of increase [1.00-1.09]) were identified as independent predictive factors of DM. Diabetic patients were on beta blockers (46.7% (n = 64) vs. 27.5% (n = 140), P < 0.001) and diuretics (51.1% (n = 70) vs. 33.2% (n = 169), p < 0.001) more frequently than non-diabetics. After a median follow-up of 22 months [IQR 7.5-63.0], 6.9% of patients developed DM, with no difference between those undergoing adrenalectomy and those treated medically (HR 1.07 [0.49-2.36], p = 0.866). There was also no significant difference in the evolution of glycemic control between DM patients who underwent surgery and those medically treated (p > 0.05).
Conclusion: DM affects about one quarter of patients with PA and the risk factors for its development are common to those of the general population. Medical and surgical treatment provides similar benefit in glycemic control in patients with PA and DM.
CITATION J Endocrinol Invest. 2023 Apr 10. doi: 10.1007/s40618-023-02090-8
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