Key result
KCNJ5-mutated APAs are linked to less metabolic syndrome and abdominal obesity vs IHA and non-mutated APAs.
Why the study?
The relationship between aldosterone overproduction, metabolic disturbances, and KCNJ5 mutations in primary aldosteronism subtypes was inconsistently linked and needed clarification.
Is the presence of KCNJ5 mutations in aldosterone-producing adenomas associated with a lower prevalence of metabolic syndrome and abdominal obesity compared to other primary aldosteronism subtypes?
Observational (n=421)
Is the presence of KCNJ5 mutations in aldosterone-producing adenomas associated with a lower prevalence of metabolic syndrome and abdominal obesity compared to other primary aldosteronism subtypes?
KCNJ5 mutations in aldosterone-producing adenomas are associated with a lower baseline prevalence of metabolic syndrome and abdominal obesity, which paradoxically worsen 1-year postadrenalectomy.
KCNJ5-mutated APAs were associated with lower metabolic syndrome rates; leaves open whether genotyping informs PA management or post-adrenalectomy outcomes.
OBJECTIVE: Aldosterone overproduction and lipid metabolic disturbances between idiopathic hyperaldosteronism (IHA) and unilateral aldosterone-producing adenoma (APA) have been inconsistently linked in patients with primary aldosteronism. Moreover, KCNJ5 mutations are prevalent among APAs and enhance aldosterone synthesis in adrenal cortex. We aimed to investigate the prevalence of metabolic syndrome (MetS) in each primary aldosteronism subtype and observe the role of KCNJ5 mutations among APAs on the distribution of abdominal adipose tissues quantified using computed tomography (CT), including their changes postadrenalectomy. DESIGN AND METHODS: We retrospectively collected 244 and 177 patients with IHA and APA at baseline. Patients with APA had undergone adrenalectomy, and gene sequencing revealed the absence (n = 75) and presence (n = 102) of KCNJ5 mutations. We also recruited 31 patients with APA who had undergone CT-scan 1-year postadrenalectomy. RESULTS: The patients with APA harbouring KCNJ5 mutations had significantly lower prevalence of MetS and smaller distribution in waist circumference, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) than the other groups. Logistic regression analysis indicated that the VAT area correlated significantly with KCNJ5 mutations among the APAs. Only participants with KCNJ5 mutations had significant increases in triglycerides, cholesterol, SAT, and VAT after 1-year postadrenalectomy. CONCLUSION: This study is the first to demonstrate that MetS and abdominal obesity were less prevalent in the patients with APA harbouring KCNJ5 mutations compared with the IHA group and the non-KCNJ5-mutated APA group. Increasing prevalence of dyslipidaemia and abdominal obesity was observed in patients with KCNJ5 mutations 1-year postadrenalectomy.
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A 2021 study conducted an observational in Primary aldosteronism (n=421). KCNJ5 mutations vs. Idiopathic hyperaldosteronism and non-KCNJ5-mutated aldosterone-producing adenoma was evaluated on Prevalence of metabolic syndrome (MetS) and distribution of abdominal adipose tissues. Aldosterone-producing adenomas harboring KCNJ5 mutations were associated with a significantly lower prevalence of metabolic syndrome and abdominal obesity compared to IHA and non-mutated APAs.
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