Visceral adiposity as a predictor of new-onset diabetes in patients with primary aldosteronism: a cohort study

Background: Patients with primary aldosteronism (PA) exhibit a high prevalence of diabetes mellitus (DM). However, the relationship between visceral adipose tissue (VAT) and new-onset diabetes mellitus (NODM) in PA patients remains unclear. Objectives: To explore the association between VAT and the risk of NODM in PA patients. Design: This is a prospective cohort study spanning 10 years (2010–2020). Methods: A total of 342 PA patients were enrolled prospectively. Abdominal adiposity indexes, including VAT area, VAT ratio, subcutaneous adipose tissue (SAT) area, and SAT ratio, were measured using a computed tomography-based software at diagnosis. Results: Of 342 PA patients (46.2% male, mean age 50.8 ± 11.2 years), 35 (10.2%) developed NODM over a mean follow-up of 7.4 years. A positive nonlinear association between NODM risk and Log (VAT ratio) ⩾ −0.72 was observed (high-VAT group). High VAT (odds ratio (OR), 6.09; p = 0.005), older age (OR, 1.09; p