Association between renal sinus fat and cardiometabolic and renin-angiotensin system parameters in primary aldosteronism
Ryunosuke Mitsuno, Kenji Kaneko, Toshifumi Nakamura, Daiki Kojima, Yosuke Mizutani, Tatsuhiko Azegami, Shintaro Yamaguchi, Yoshitake Yamada, Masahiro Jinzaki, Kenichiro Kinouchi, Jun Yoshino, Kaori Hayashi- Endocrinology, Diabetes and Metabolism
Abstract
Context
Renal sinus fat (RSF) accumulation is associated with cardiometabolic diseases, such as obesity, diabetes, hypertension, and chronic kidney disease. However, clinical implications of RSF in primary aldosteronism (PA) remain unclear.
Objective
We aimed to investigate relationships between RSF volume and key cardiometabolic and renin-angiotensin system (RAS) parameters in PA patients and clarify the differences in these relationships between unilateral and bilateral subtypes.
Methods
We analyzed data obtained from well-characterized PA patients that involved 45 unilateral (median age: 52 years; 42.2% men) and 92 bilateral patients (51 years; 42.4% men).
Results
RSF volume normalized by renal volume (RSF%) was greater in unilateral group than in bilateral group (P < 0.05). RSF% was greater in males than in females (P < 0.05). RSF% positively correlated with parameters related to cardiometabolic risk, including age, body mass index, visceral fat volume, creatinine, triglyceride/high-density lipoprotein cholesterol ratio, uric acid, fasting glucose, and C-reactive protein regardless of PA subtypes (all P < 0.05). Intriguingly, RSF% positively correlated with plasma aldosterone concentration (PAC), aldosterone-to-renin ratio, and intact parathyroid hormone (iPTH) (all P < 0.05) in bilateral patients but it did not correlate with RAS parameters and even showed an opposite trend in unilateral patients. In subgroup analyses by sex, these distinctions became more evident in females. After adjustment for potential confounders, RSF% remained positively correlated with PAC and iPTH in bilateral patients.
Conclusions
Our results indicate that RSF accumulation is involved in cardiometabolic dysfunction associated with PA. However, there were distinct correlations between RSF volume and RAS parameters according to gender and PA subtypes.