1. The Aldosterone/Renin Ratio Predicts Cardiometabolic Disorders in Subjects Without Classic Primary Aldosteronism
- Author
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Sandra Solari, Andrea Vecchiola, Roberto Olmos, Eric Barros, Cristobal A. Fuentes, Alexis M. Kalergis, Alejandra Tapia-Castillo, Hernán García, Cristian A. Carvajal, Carmen Campino, Alejandro Martinez-Aguayo, Fidel Allende, Rene Baudrand, and Carlos E. Fardella
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.drug_class ,Population ,Blood Pressure ,030204 cardiovascular system & hematology ,Plasma renin activity ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Primary aldosteronism ,Internal medicine ,Renin–angiotensin system ,Hyperaldosteronism ,Renin ,Internal Medicine ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,education ,Aldosterone ,Metabolic Syndrome ,education.field_of_study ,business.industry ,Odds ratio ,medicine.disease ,Prognosis ,Endocrinology ,Cross-Sectional Studies ,chemistry ,Mineralocorticoid ,Hypertension ,Disease Progression ,Female ,Metabolic syndrome ,business ,Biomarkers - Abstract
BACKGROUND Aldosterone has been linked with obesity, metabolic syndrome (MetS), pro-inflammatory, and prothrombotic states; however, most studies relate these indicators with primary aldosteronism (PA), excluding non-PA patients. OBJECTIVE To determine whether aldosterone, renin, or the plasma aldosterone/renin ratio (ARR) are associated with metabolic disorders and inflammatory/vascular biomarkers in a non-PA population. METHODS We studied 275 patients including adolescents and adults of both genders and measured plasma and urinary aldosterone and determined the plasma renin activity. In all subjects, the presence of MetS was determined according to Adult Treatment Panel III. Renal, vascular, inflammatory, and mineralocorticoid activity biomarkers were evaluated. RESULTS The ARR correlated with the number of variables of MetS (r = 0.191, P = 0.002), body mass index (BMI; r = 0.136, P = 0.026), systolic blood pressure (r = 0.183, P = 0.002), diastolic blood pressure (r = 0.1917, P = 0.0014), potassium excreted fraction (r = 0.174, P = 0.004), low-density lipoprotein (r = 0.156, P = 0.01), plasminogen activator inhibitor type 1 (r = 0.158, P = 0.009), microalbuminuria (r = 0.136, P = 0.029), and leptin (r = 0.142, P = 0.019). In a linear regression model adjusted by age, BMI, and gender, only the ARR was still significant (r = 0.108, P = 0.05). In a logistic regression analysis, the ARR predicted MetS index (odds ratio (OR) = 1.07 [95% confidence interval (CI) = 1.011–1.131], P= 0.02) even after adjusting for age, BMI, and gender. On the other hand, aldosterone showed no association with MetS or inflammatory markers. CONCLUSION These results suggest a continuum of cardiometabolic risk beyond the classic PA threshold screening. The ARR could be a more sensitive marker of obesity, MetS, and endothelial damage in non-PA patients than aldosterone or renin alone. Prospective studies are needed to develop future screening cutoff values.
- Published
- 2019