Key result
Renal sinus fat accumulation is linked to adverse cardiometabolic risk and higher aldosterone in primary aldosteronism.
Why the study?
Renal sinus fat accumulation is linked to cardiometabolic diseases, but its clinical implications in primary aldosteronism remain unclear.
Cross-Sectional (n=137)
No
Effect estimate: Standardized coefficient β 0.27 (95% CI 0.09-0.36)
p-value: p=<0.001
Renal sinus fat accumulation is linked to cardiometabolic dysfunction in primary aldosteronism, with distinct correlations with renin-angiotensin system parameters between unilateral and bilateral subtypes.
Renal sinus fat may mark cardiometabolic risk in primary aldosteronism; leaves open subtype-specific mechanisms and therapeutic targets.
Context Renal sinus fat (RSF) accumulation is associated with cardiometabolic diseases, such as obesity, diabetes, hypertension, and chronic kidney disease. However, clinical implications of RSF in primary aldosteronism (PA) remain unclear. Objective We aimed to investigate relationships between RSF volume and key cardiometabolic and renin-angiotensin system (RAS) parameters in PA patients and clarify the differences in these relationships between unilateral and bilateral subtypes. Methods We analyzed data obtained from well-characterized PA patients that involved 45 unilateral (median age: 52 years; 42.2% men) and 92 bilateral patients (51 years; 42.4% men). Results RSF volume normalized by renal volume (RSF%) was greater in the unilateral group than in the bilateral group (P < .05). RSF% was greater in men than in women (P < .05). RSF% positively correlated with parameters related to cardiometabolic risk, including age, body mass index, visceral fat volume, creatinine, triglycerides/high-density lipoprotein cholesterol ratio, uric acid, fasting glucose, and C-reactive protein regardless of PA subtypes (all P < .05). Intriguingly, RSF% positively correlated with plasma aldosterone concentration (PAC), aldosterone-to-renin ratio, and intact parathyroid hormone (iPTH) (all P < .05) in bilateral patients but did not correlate with RAS parameters and even showed an opposite trend in unilateral patients. In subgroup analyses by sex, these distinctions became more evident in women. After adjustment for potential confounders, RSF% remained positively correlated with PAC and iPTH in bilateral patients. Conclusion Our results indicate that RSF accumulation is involved in cardiometabolic dysfunction associated with PA. However, there were distinct correlations between RSF volume and RAS parameters according to sex and PA subtypes.
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Mitsuno et al. (2023) conducted a cross-sectional in Primary Aldosteronism (n=137). Renal sinus fat (RSF) volume was evaluated on Correlation between log-transformed renal sinus fat volume normalized by renal volume (RSF%) and plasma aldosterone concentration (PAC) in bilateral patients (Model 3) (Standardized coefficient β 0.27, 95% CI 0.09-0.36, p=<0.001). Renal sinus fat accumulation was associated with adverse cardiometabolic risk parameters across all subtypes, and positively correlated with plasma aldosterone concentration in bilateral primary aldosteronism.
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