Clinical Significance of Skeletal Fat-to-Muscle Ratio in Idiopathic Hyperaldosteronism

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-05-20 DOI:10.1111/cen.15274

Yuhe Jiang, Dan Li, Cassie Chen Cao, Wenjing Feng, Ruidong Liu, Yinfei Xu, Caixia Cao

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Abstract

Objective

The objective of this study is to evaluate the correlation between the fat-to-muscle ratio (FMR) and insulin resistance (IR) with aldosterone production among patients with idiopathic hyperaldosteronism (IHA).

Methods

Patients with primary aldosteronism were screened from those with secondary hypertension and then subtyped via adrenal venous sampling. A total of 199 patients with IHA and 186 with essential hypertension (EH) (controls) were studied. Baseline clinical characteristics, including data on diabetes and IHA, were collected. The FMR was evaluated based on the distribution of adipose tissue and muscle, measured by a body composition analyzer.

Results

The prevalence of diabetes and prediabetes was significantly higher in patients with IHA compared to those with essential hypertension. IHA patients also had significantly higher hemoglobin A1c(HbA1c) levels, homeostatic model assessment of insulin resistance (HOMA-IR), and much lower quantitative insulin sensitivity check index scores than the EH group. FMR was positively associated with fasting insulin, HOMA-IR, aldosterone-to-renin ratio (ARR), and age. A higher FMR was linked to the prevalence of IHA, with a stepwise increase in risk observed from the lowest to the highest quartiles of FMR. Logistic regression analysis showed that both HOMA-IR and body mass index contributed to the elevated FMR. IHA may result from a substantial loss of muscle mass accompanied by fat accumulation.

Discussion

In this retrospective study, our findings suggest that FMR could serve as a valuable metric for early intervention and comanagement strategies in patients at risk of sarcopenic obesity. This approach could help block the progression from aldosterone-producing cell clusters to IHA, potentially inhibiting aldosterone overproduction in such patients.

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特发性高醛固酮增多症骨骼肌脂肪比的临床意义。

目的：本研究的目的是评估特发性高醛固酮血症（IHA）患者的脂肌比（FMR）和胰岛素抵抗（IR）与醛固酮产生的相关性。方法：从继发性高血压患者中筛选出原发性醛固酮增多症患者，通过肾上腺静脉取样进行分型。共研究了199例IHA患者和186例原发性高血压（EH）患者（对照组）。收集基线临床特征，包括糖尿病和IHA数据。FMR是根据脂肪组织和肌肉的分布来评估的，由身体成分分析仪测量。结果：IHA患者糖尿病和前驱糖尿病的患病率明显高于原发性高血压患者。与EH组相比，IHA患者的血红蛋白A1c（HbA1c）水平、胰岛素抵抗稳态模型评估（HOMA-IR）和定量胰岛素敏感性检查指数得分也明显更高。FMR与空腹胰岛素、HOMA-IR、醛固酮与肾素比值（ARR）和年龄呈正相关。较高的FMR与IHA患病率有关，从FMR的最低四分位数到最高四分位数的风险逐步增加。Logistic回归分析显示，HOMA-IR和体重指数均与FMR升高有关。IHA可能是由于肌肉量的大量减少和脂肪的积累造成的。讨论：在这项回顾性研究中，我们的研究结果表明，FMR可以作为有肌少性肥胖风险患者早期干预和管理策略的有价值的指标。这种方法可以帮助阻止从醛固酮产生细胞簇到IHA的进展，潜在地抑制此类患者醛固酮过量产生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.