Abstract:
Objective To explore the insulin sensitivity and pancreatic β cell function in patients with primary aldosteronism (PA).
Methods 95 PA patients and 210 essential hypertension (EH) patients were admitted in Shanghai Fifth People's Hospital, Fudan University from January 2014 to December 2015. The insulin resistance and β cell function in PA and EH patients were analyzed according to the history of diabetes. According to whether the activity of aldosterone to active renin ration (ARR) was greater than 50, PA patients were divided into high PA group (45 cases) and low PA group (50 cases). QUICK index and HOMA-IR were used to evaluate the insulin sensitivity, the HOMA-β cell index and first phase insulin secretion (ΔI30/ΔG30) were used to assess the pancreatic β cell function.
Results Univariate analysis showed that, for patients without history of diabetes, HOMA-β in the high PA group was lower than that in the EH group (P < 0.05), and ΔI30/ΔG30 in the high PA and low PA groups was lower than that in the EH group (P < 0.05). While for patients with history of diabetes, only HOMA-β in the high PA group was lower than that in the EH group (P < 0.05). The results of multiple linear regression showed that, the level of upright plasma aldosterone had a significant negative effect on LnΔI30/ΔG30 in non-diabetic patients (β=-0.375, P < 0.05). And the level of upright plasma had significant negative effect on LnHOMA-β in patients with history of diabetes (β=-0.367, P < 0.01). Aldosterone level had no significant effect on insulin resistance regardless of diabetes history.
Conclusions The abnormality of glucose metabolism caused by primary hyperaldosteronism may be related to the dysfunction of islet function induced by elevated aldosterone.
下载: