Insulin sensitivity in 32 patients with primary aldosteronism

AIM To determine the outcome of insulin sensitivity in patients with primary aldosteronism before and after treatment. METHEDS Of the 32 patients who had been diagnosed as having primary aldosteronism (PA) in 303 Hospital from 2001 to November 2007, 20 case were diagnosed as having aldosterone-producing adenoma (APA) and 12 cases as idiopathic hyperaldosteronism (IHA). BMI, BP, plasma potassium concentration, aldosterone, FBG, fasting INS, and HOMAIR were observed in all the patients. RESULTS The SBP（140±8.6）mmHg, DBP（82±9）mmHg, fasting INS（7.6±1.8）mmol/L, FBG（5.0±0.7）mmol/Land HOMAIR（1.6±0.4） were significantly lower in patients with PA after treatment as compared with those in the same patients before treatment［SBP（178±10）mmHg, DBP（105 ±11）mmHg, fasting INS（10±3）mmol/L, FBG（5.6±1.1）mmol/L and HOMAIR（2.4±0.9） (all P<0.01)］ . Before treatment, the aldosterone (ALD) concentration（228±52）ng/L was significantly lower in patients with IHA as compare with that in the APA group（344±41)ng/L,（P<0.01） and the prevalence of insulin resistance（58%） was significantly higher in patients with IHA than that in patients with APA（20%, P<0.05）. The aldosterone concentration (82±23) ng/L was significantly lower in patients with APA after treatment with surgery than that in the same patients before treatment (301±72)ng/L（P<0.01）. After treatment the plasma potassium concentration was significantly higher in APA group（4.0±0.4）mmol/L and HIA group（4.1±0.4）mmol/Las compare with the same patients before treatment［（3.2±0.4）mmol/L,（3.4±0.3）mmol/L（all P<0.01）］. CONCLUSION SInsulin resistance is present in patients with tumoral and idiopathic aldosteronism. Treatment with surgery or aldosterone antagonists can improve the insulin sensitivity.