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Araujo-Castro M, Paja Fano M, Pla Peris B, González Boillos M, Pascual-Corrales E, García Cano AM, Parra Ramírez P, Martín Rojas-Marcos P, Ruiz-Sanchez JG, Vicente Delgado A, Gómez Hoyos E, Ferreira R, García Sanz I, Recasens Sala M, Barahona San Millan R, Picón César MJ, Díaz Guardiola P, Perdomo CM, Manjón Miguélez L, García Centeno R, Percovich JC, Rebollo Román Á, Gracia Gimeno P, Robles Lázaro C, Morales-Ruiz M, Calatayud Gutiérrez M, Furio Collao SA, Meneses D, Sampedro Nuñez MA, Escudero Quesada V, Mena Ribas E, Sanmartín Sánchez A, Gonzalvo Diaz C, Lamas C, Guerrero-Vázquez R, Del Castillo Tous M, Serrano Gotarredona J, Michalopoulou Alevras T, Moya Mateo EM, Hanzu FA. Prevalence, risk factors and evolution of diabetes mellitus after treatment in primary aldosteronism. Results from the SPAIN-ALDO registry. J Endocrinol Invest 2023; 46:2343-2352. [PMID: 37037973 DOI: 10.1007/s40618-023-02090-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/05/2023] [Indexed: 04/12/2023]
Abstract
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.
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Affiliation(s)
- M Araujo-Castro
- Endocrinology and Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Colmenar Viejo Street Km 9, 28034, Madrid, Spain.
- University of Alcalá, Madrid, Spain.
| | - M Paja Fano
- Endocrinology and Nutrition Department, OSI Bilbao-Basurto, Hospital Universitario de Basurto, Bilbao, Spain
- Medicine Department, Basque Country University, Bilbao, Spain
| | - B Pla Peris
- Endocrinology and Nutrition Department, Hospital Universitario de Castellón, Castellón, Spain
| | - M González Boillos
- Endocrinology and Nutrition Department, Hospital Universitario de Castellón, Castellón, Spain
| | - E Pascual-Corrales
- Endocrinology and Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Colmenar Viejo Street Km 9, 28034, Madrid, Spain
| | - A M García Cano
- Biochemistry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - P Parra Ramírez
- Endocrinology and Nutrition Department, Hospital Universitario La Paz Madrid, Madrid, Spain
| | - P Martín Rojas-Marcos
- Endocrinology and Nutrition Department, Hospital Universitario La Paz Madrid, Madrid, Spain
| | - J G Ruiz-Sanchez
- Endocrinology and Nutrition Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - A Vicente Delgado
- Endocrinology and Nutrition Department, Hospital Universitario de Toledo, Toledo, Spain
| | - E Gómez Hoyos
- Endocrinology and Nutrition Department, Hospital Universitario de Valladolid, Valladolid, Spain
| | - R Ferreira
- Endocrinology and Nutrition Department, Hospital Universitario Rey Juan Carlos, Madrid, Spain
| | - I García Sanz
- General and Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - M Recasens Sala
- Endocrinology and Nutrition Department, Institut Català de La Salut Girona, Girona, Spain
| | - R Barahona San Millan
- Endocrinology and Nutrition Department, Institut Català de La Salut Girona, Girona, Spain
| | - M J Picón César
- Endocrinology and Nutrition Department, Hospital Universitario Virgen de La Victoria de Málaga, IBIMA, Málaga, Spain
- CIBEROBN, Madrid, Spain
| | - P Díaz Guardiola
- Endocrinology and Nutrition Department, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - C M Perdomo
- Endocrinology and Nutrition Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - L Manjón Miguélez
- Endocrinology and Nutrition Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - R García Centeno
- Endocrinology and Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - J C Percovich
- Endocrinology and Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Á Rebollo Román
- Endocrinology and Nutrition Department, Hospital Reina Sofía, Córdoba, Spain
| | - P Gracia Gimeno
- Endocrinology and Nutrition Department, Hospital Rollo Villanova, Saragossa, Spain
| | - C Robles Lázaro
- Endocrinology and Nutrition Department, Complejo Universitario de Salamanca, Salamanca, Spain
| | - M Morales-Ruiz
- Biochemistry and Molecular Genetics Department-CDB, CIBERehd, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | | | - S A Furio Collao
- Endocrinology and Nutrition Department, Hospital Doce de Octubre, Madrid, Spain
| | - D Meneses
- Endocrinology and Nutrition Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M A Sampedro Nuñez
- Endocrinology and Nutrition Department, Hospital Universitario La Princesa Madrid, Madrid, Spain
| | - V Escudero Quesada
- Nephrology Department, Hospital Universitario Doctor Peser, Valencia, Spain
| | - E Mena Ribas
- Endocrinology and Nutrition Department, Hospital Universitario Son Espases, Palma, Islas Baleares, Spain
| | - A Sanmartín Sánchez
- Endocrinology and Nutrition Department, Hospital Universitario Son Espases, Palma, Islas Baleares, Spain
| | - C Gonzalvo Diaz
- Endocrinology and Nutrition Department, Hospital Universitario De Albacete, Albacete, Spain
| | - C Lamas
- Endocrinology and Nutrition Department, Hospital Universitario De Albacete, Albacete, Spain
| | - R Guerrero-Vázquez
- Endocrinology and Nutrition Department, Hospital Virgen de La Macarena, Seville, Spain
| | - M Del Castillo Tous
- Endocrinology and Nutrition Department, Hospital Virgen de La Macarena, Seville, Spain
| | - J Serrano Gotarredona
- Endocrinology and Nutrition Department, Hospital General Universitario de Alicante, Alicante, Spain
| | | | - E M Moya Mateo
- Internal Medicine, Hospital Infanta Leonor de Vallecas, Madrid, Spain
| | - F A Hanzu
- Endocrinology and Nutrition Department, Hospital Clinic, IDIPAS, Barcelona, Spain
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