SHORT COMMUNICATION
Does the Treatment of Primary Hyperaldosteronism Influence
Glucose Tolerance?
B. ŠTRAUCH, J. WIDIMSKÝ Jr.,
†G. ŠINDELKA, J. ŠKRHA
Third Department of Internal Medicine, First Faculty of
Medicine, Charles University, Prague, Czech Republic
Received March 13, 2002
Accepted September 6, 2002
Summary
Primary hyperaldosteronism (PH) is frequently considered to be a
secondary form of diabetes mellitus (DM). In our previous study
we attempted to evaluate the prevalence of DM among patients
with PH compared to control subjects with essential hypertension
(EH). We have noted a relatively high prevalence of DM and
impaired glucose tolerance in PH, but the differences between
the PH and EH groups did not reach statistical significance. We
performed this study to assess whether the effective treatment
of PH (surgical and conservative) would improve the glucose
tolerance. We have studied 24 patients with PH of the following
two subtypes: aldosterone-producing adenoma (APA) treated with
adrenalectomy and idiopathic hyperaldosteronism (IHA) treated
with spironolactone. No significant changes of glucose levels
were found in the 60th and 120th min of the oral glucose
tolerance test (OGTT) in the APA group. On the other hand,
fasting glucose levels were decreased significantly after
adrenalectomy. Plasma glucose levels were significantly
increased in the 60th min, but no differences were found in
fasting values and in the 120th min in the IHA group. There was
a significantly higher incidence of impaired glucose tolerance
(36 % before, 45 % after treatment) and DM (9 %, 18 %) in the
IHA group compared to the APA group (8 %, 32 %; DM 0 %, 0 %). In
conclusion, the treatment of PH does not improve glucose
tolerance. Mild worsening of glucose tolerance after treatment
could be explained by an increase of the body mass index. These
data, in accordance with our previous study, do not support the
idea that PH is a secondary form of diabetes mellitus.
Key
words
Primary hyperaldosteronism • Blood pressure • Impaired
glucose tolerance
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MUDr. B. Štrauch, Third Department of Internal Medicine, First
Faculty of Medicine, Charles University, U nemocnice 1, 128 08
Prague 2, Czech Republic e-mail:
strauch@volny.cz
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