Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio

Area of Science:

• Endocrinology
• Bone Metabolism
• Cardiovascular Health

Background:

• Plasma aldosterone/renin ratio (ARR) is a key screening tool for primary aldosteronism (PA).
• Medications and diet can confound ARR results, leading to inaccurate screening.
• The relationship between postmenopausal osteoporosis (PMO) and ARR requires further investigation.

Purpose of the Study:

• To investigate the association between postmenopausal osteoporosis (PMO) and plasma ARR in normotensive postmenopausal women.
• To determine if PMO influences plasma aldosterone concentration (PAC) and plasma renin concentration (PRC) levels.
• To assess the impact of PMO on the accuracy of PA screening using ARR.

Main Methods:

• Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA) in 324 women.
• Subjects were categorized into PMO, osteopenia, and normal BMD groups.
• Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), parathyroid hormone (PTH), bone alkaline phosphatase (BALP), and 25-Hydroxyvitamin D were measured.

Main Results:

• Women with PMO exhibited significantly higher PAC and ARR compared to those with normal BMD and osteopenia.
• A higher rate of false-positive ARR results was observed in the PMO group (24%) compared to normal BMD (2%) and osteopenia (7%) groups.
• PAC showed a negative correlation with lumbar spine, femur neck, and total hip BMD T-scores. PTH was positively associated with PAC and ARR.

Conclusions:

• Elevated PAC and ARR levels are associated with PMO in postmenopausal women.
• PMO may contribute to an increased risk of false-positive PA screening results.
• These findings highlight the importance of considering bone health status when interpreting ARR for PA screening.