Adipose Composition Before and After Primary Aldosteronism Treatment Depends on Primary Aldosteronism Subtypes and Plasma Aldosterone Concentration Before the Treatment

The abdominal and ectopic fats increase after primary aldosteronism (PA) treatment in aldosterone-producing adenoma (APA) but not idiopathic hyperaldosteronism (IHA) has been reported. Additionally, the relationship of these fats to plasma aldosterone concentration remains unclear. This retrospective study aimed to elucidate the influence of aldosterone on body composition. We compared the body composition parameters of APA and IHA patients at baseline and after PA treatment. APA patients tended to have a smaller subcutaneous fat area (SFA) than IHA patients at baseline. The SFA, visceral fat area (VFA) and dyslipidemia prevalence of APA patients but not IHA patients significantly increased after PA treatment. The SFA and the VFA change after adrenalectomy were positively correlated with the baseline plasma aldosterone concentration (PAC) in APA patients. At baseline, APA patients' intramuscular adipose tissue content (IMAC) was significantly less than that of IHA patients. The IMAC of PA patients at baseline was negatively correlated with PAC. The IMAC of APA patients but not IHA patients significantly increased after PA treatment. This study demonstrated that SFA, VFA and IMAC increased after PA treatment in APA patients but not in IHA patients, thereby suggesting a relationship between body composition and aldosterone.