Co-existing autonomous cortisol secretion in primary aldosteronism.

Area of Science:

• Endocrinology
• Internal Medicine
• Cardiology

Background:

• Primary aldosteronism (PA) and autonomous cortisol secretion (ACS) are increasingly recognized as co-existing endocrine disorders.
• Understanding the incidence and impact of co-existing ACS in PA patients is crucial for clinical management.

Purpose of the Study:

• To determine the incidence of autonomous cortisol secretion (ACS) in patients diagnosed with primary aldosteronism (PA).
• To evaluate the impact of co-existing ACS on clinical and laboratory parameters in PA patients.

Main Methods:

• Retrospective analysis of demographic data, comorbidities, and laboratory/imaging results from 92 PA patients.
• Classification of patients into PA with ACS or PA without ACS groups based on overnight 1mg dexamethasone suppression test results (>1.8μg/dL for PA with ACS).

Main Results:

• Twenty-four patients (26.1%) were diagnosed with PA and co-existing ACS.
• The PA-with-ACS group exhibited higher mean age, body mass index, proportion of female patients, and maximum adenoma diameter.
• Patients without ACS had significantly higher basal and post-saline infusion plasma aldosterone concentrations (PAC).
• No significant differences in antihypertensive treatment, diabetes, coronary artery disease, proteinuria, or glomerular filtration rate were observed between groups.
• Left ventricular hypertrophy (LVH) was present in 49.4% of patients, with PAC and gender being associated factors.

Conclusions:

• Cortisol co-secretion (ACS) occurs in approximately one-quarter of PA patients.
• PA patients without ACS demonstrated higher PAC compared to those with co-existing ACS.
• Co-existing ACS in PA patients did not appear to significantly negatively impact clinical parameters in this cohort.