Can primary
Hyperaldosteronism be Considered as a Specific
Form of Diabetes Mellitus?
J.
WIDIMSKÝ Jr, B. STRAUCH, †G.
ŠINDELKA, J. ŠKRHA
Third
Internal Department, General Faculty Hospital,
First Medical Faculty, Charles University,
Prague, Czech Republic
†Dr. Gustav
Šindelka died tragically on September 23, 2001
Received
December 6, 2000
Accepted March 15, 2001
Summary
Aldosterone-producing
adenoma (aldosteronoma) - the most frequent form
of primary hyperaldosteronism (PH) - is
considered a specific form of diabetes mellitus
(DM). In a previous study we demonstrated insulin
resistance in patients with PH. We have therefore
undertaken a study to evaluate the incidence of
abnormalities of glucose metabolism in patients
with PH (36 subjects) compared to control
subjects with essential hypertension (EH) (21
patients). The following parameters were measured
in all studied subjects: office blood pressure
(by mercury sphygmomanometer in the sitting
position), body mass index (BMI), plasma
potassium, plasma glucose and insulin levels
during oral glucose tolerance test (OGTT) (0, 60,
120 min), plasma renin activity and plasma
aldosterone. Although patients with PH tended to
have higher stimulated plasma glucose levels
after 60 and 120 min compared to EH, these
differences did not attain statistical
significance. Patients with EH tended to have
higher insulin levels at each measured interval,
but due to a high variability these differences
were again not significant. There were no
significant differences between PH and EH in the
proportion of diabetics (20 % vs. 14 %) or
patients with impaired glucose tolerance (18 %
vs. 10 %). In conclusion, we have found the
absence of significant differences in the
frequency of diabetes mellitus, impaired glucose
tolerance and insulin resistance in patients with
EH and PH. Our data thus do not support the idea
of primary hyperaldosteronism as a specific type
of diabetes mellitus. Furthermore, our results
indicate that glucose metabolic characteristics
in essential hypertension and primary
hyperaldosteronism tend to be similar. The
definitive conclusion with respect to the
possible causal relationship between DM and PH,
however, can be obtained only on larger groups of
subjects, in particular after the evaluation of
the effect of surgical/pharmacological treatment
of primary hyperaldosteronism.
.
Key words
Primary
hyperaldosteronism · Specific type · Diabetes mellitus · Insulin
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Dr.
J. Widimský Jr, Third Internal Department,
Faculty Hospital, First Faculty of Medicine, U
nemocnice 1, 128 21 Prague 2, Czech Republic
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