Causal effects of primary aldosteronism on inflammation and bone density: evidence from Mendelian randomization,...

Studies on the pro-inflammatory effects of primary aldosteronism (PA) in humans have largely relied on measurements of circulating inflammatory biomarkers and are mostly observational in nature, making it difficult to establish a causal relationship between PA and inflammatory responses. In addition, the association between PA and bone mineral density (BMD) remains controversial and warrants further investigation.

This study aimed to evaluate the causal effects of PA on circulating inflammatory proteins and bone mineral density.

We performed a Mendelian randomization (MR) analysis to assess the causal relationships between PA and 91 circulating inflammatory proteins, as well as BMD at four anatomical sites. The findings were further validated using a rat model and clinical data.

MR analysis revealed significant inverse causal associations between PA and the circulating levels of interleukin-10 receptor subunit beta (IL-10RB) and hepatocyte growth factor (HGF). These findings were further supported by the rat model results, in which serum IL-10RB (2.10 ± 1.18 ng/mL) and HGF (1120.95 ± 144.33 pg/mL) levels in the Aldo-salt group were significantly lower than those in both the Aldo-salt-Epl group (4.80 ± 1.40 ng/mL and 1434.74 ± 192.45 pg/mL, respectively) and the control group (5.07 ± 0.79 ng/mL and 1540.42 ± 316.32 pg/mL, respectively) (P < 0.05). Consistently, clinical data showed that patients with PA had significantly lower serum IL-10Rb and HGF levels compared to those with essential hypertension (EH) (1146.20 ± 178.23 vs. 1660.49 ± 238.44 pg/mL and 1082.93 ± 231.47 vs. 1935.18 ± 296.44 pg/mL, respectively; P < 0.001 for both). Notably, MR analysis did not identify any significant causal associations between PA and bone mineral density at the total body, forearm, femoral neck, or lumbar spine.

This study is the first to demonstrate a causal relationship between PA and reduced circulating levels of IL-10RB and HGF, suggesting that PA may promote disease progression by impairing anti-inflammatory defenses and providing new insights for diagnostic and therapeutic strategies targeting inflammation-related pathways.