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Prevalence of primary aldosteronism among patients with type 2 diabetes
Author(s) -
Tancredi Mauro,
Johannsson Gudmundur,
Eliasson Björn,
Eggertsen Robert,
Lindblad Ulf,
Dahlqvist Sofia,
Imberg Henrik,
Lind Marcus
Publication year - 2017
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13370
Subject(s) - medicine , primary aldosteronism , aldosterone , type 2 diabetes , diabetes mellitus , endocrinology , cohort , hyperaldosteronism , blood pressure , nephropathy , outpatient clinic , diabetic retinopathy , plasma renin activity , renin–angiotensin system
Summary Context Diabetes and hypertension coexist in 40%‐60% of individuals with type 2 diabetes. The coexistence of these two conditions is associated with increased risk of retinopathy, nephropathy and cardiovascular disease. Objective To investigate the prevalence of primary aldosteronism ( PA ) in a general cohort of persons with type 2 diabetes. Design Cross‐sectional study involving six diabetes outpatient clinics in Sweden. Patients were enrolled individuals with type 2 diabetes between February 2008 and December 2013. Measurements Plasma aldosterone concentrations ( PAC pmol/L) and direct renin concentrations ( DRC mIU /L) were measured. Patients with increased aldosterone renin ratios ( ARR ) >65 were further evaluated for PA . Results Of 578 consecutively screened patients with type 2 diabetes, 27 were treated with mineralocorticoid receptor antagonists ( MRA ) and potassium‐sparing diuretics not further evaluated. Among the remaining 551 patients, 38 had increased ARR , including 22 who were clinically indicated for PA tests and 16 who were not further evaluated due to severe comorbidities and old age. There were five (0.93%) patients with confirmed PA after computerized tomography and adrenal venous sampling. Patients with PA had higher systolic blood pressure ( P =.032) and lower potassium levels ( P =.027) than those without PA . No significant association was found between plasma aldosterone and diabetic complications. Conclusions The prevalence of PA in an unselected cohort of patients with type 2 diabetes is relatively low, and measures of plasma aldosterone are not strong risk factors for micro‐ and macrovascular diabetic complications.