Obesity and the diagnostic accuracy for primary aldosteronism

Amit Tirosh*, Fady Hannah-Shmouni, Charalampos Lyssikatos, Elena Belyavskaya, Mihail Zilbermint, Smita B. Abraham, Maya B. Lodish, Constantine A. Stratakis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The effects of body mass index on the diagnostic accuracy of primary aldosteronism (PA) are inconsistent and yet important considering the high prevalence and frequent co-occurrence of obesity and hypertension. The current study included 59 adult patients who underwent a stepwise evaluation for PA, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and/or 24-hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U-shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test. Among patients with a body mass index ≥30 kg/m2, the aldosterone to renin ratio yielded lower case detection accuracy of PA. We conclude that obesity results in a nonlinear correlation with plasma aldosterone concentration, plasma renin activity, and aldosterone to renin ratio, which affects the accuracy of case detection for PA. Patients with a body mass index ≥30 kg/m2 are less accurately identified as having PA when saline suppression and/or oral salt loading tests are used for case confirmation.

Original languageEnglish
Pages (from-to)790-797
Number of pages8
JournalJournal of Clinical Hypertension
Volume19
Issue number8
DOIs
StatePublished - Aug 2017

Funding

FundersFunder number
National Institutes of Health
National Institute of Child Health and Human DevelopmentZIAHD008920
Eunice Kennedy Shriver National Institute of Child Health and Human Development

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