Arterial stiffness and blood pressure improvement in aldosterone-producing adenoma harboring KCNJ5 mutations after adrenalectomy

// Chia-Hui Chang 1, 2 , Ya-Hui Hu 1 , Yao-Chou Tsai 3 , Che-Hsiung Wu 4 , Shuo-Meng Wang 5 , Lian-Yu Lin 6 , Yen-Hung Lin 6 , Fumitoshi Satoh 7 , Kwan-Dun Wu 8 , Vin-Cent Wu 8, 9 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, Hualien, Taiwan 2 Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan 3 Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, Hualien, Taiwan 4 Division of Nephrology, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, Hualien, Taiwan 5 Division of Urology, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan 6 Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 7 Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University, Graduate School of Medicine, Sendai, Japan 8 Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 9 TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taiwan Correspondence to: Vin-Cent Wu, email: q91421028@ntu.edu.tw Keywords: KCNJ5 gene, arterial stiffness, PWV, TAIPAI, CAKS Received: August 24, 2016 Accepted: March 09, 2017 Published: March 16, 2017 ABSTRACT The aim of this study was to show the effect of KCNJ5 mutational status on arterial stiffness in aldosterone-producing adenomas after adrenalectomy. Between February 2008 and January 2010, we prospectively enrolled 108 aldosterone-producing adenoma patients undergoing adrenalectomy. We conducted repeated measurements of pulse wave velocity at baseline, 6 months, and 12 months after adrenalectomy, grouped by KCNJ5 mutational status. Prognostic factors of arterial stiffness and risk for hypertension at 12 months after adrenalectomy were analyzed after propensity score matching in a 1:1 ratio. After matching for age, sex and body mass index, 88 patients were divided equally into KCNJ5-mutant and non-mutant groups. KCNJ5 mutational status was not an independent variable in either the generalized estimating equation model ( p = 0.147) or the percentage change of brachial-ankle pulse wave velocity ( p = 0.106). The generalized additive model smoothing plot showed that aldosterone-producing adenoma patients who carried the KCNJ5 mutation and were aged between 37 and 60 may have a hypertension recovery advantage. According to our observations during a 12-month follow-up after adrenalectomy, KCNJ5 mutational status was not associated with improvement in arterial stiffness.