PMID- 30865224 OWN - NLM STAT- MEDLINE DCOM- 20200520 LR - 20210924 IS - 1945-7197 (Electronic) IS - 0021-972X (Linking) VI - 104 IP - 8 DP - 2019 Aug 1 TI - Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion. PG - 3192-3202 LID - 10.1210/jc.2019-00299 [doi] AB - CONTEXT: Primary aldosteronism (PA) is associated with higher cardiovascular morbidity and metabolic risks. Recent studies report glucocorticoid cosecretion as a relevant phenotype of PA, which could contribute to associated risks, including type 2 diabetes mellitus (T2DM). The relationship between autonomous cortisol secretion (ACS) and glucose metabolism in PA has not been investigated. OBJECTIVE: To evaluate the prevalence of impaired glucose homeostasis in patients with PA according to cortisol cosecretion. DESIGN: We performed oral glucose tolerance tests (OGTTs) and complete testing for hypercortisolism [1-mg dexamethasone suppression test (DST), late-night salivary cortisol, 24-hour urinary free cortisol] in 161 newly diagnosed patients with PA of the German Conn Registry. Seventy-six of 161 patients were reevaluated at follow-up. We compared our results to a population-based sample from the Cooperative Health Research in the Region of Augsburg (KORA)-F4 study matched to the participants with PA (3:1) by sex, age, and body mass index. RESULTS: At the time of diagnosis, 125 patients (77.6%) had a pathological response in at least one of the Cushing screening tests; T2DM was diagnosed in 6.4% of these 125 cases. Patients with a pathological DST exhibited significantly higher 2-hour plasma glucose in OGTTs and were significantly more often diagnosed with T2DM than were patients with a normal DST (20% vs 0.8%, P < 0.0001) and matched controls from the KORA study (20.6% vs 5.9%, P = 0.022). Patients with PA without ACS tended to have higher homeostatic model assessment of insulin resistance levels than did KORA control subjects (P = 0.05). CONCLUSION: ACS appears frequently in patients with PA and is associated with impaired glucose metabolism, which could increase the risk of T2DM. PA itself seems to enhance insulin resistance. CI - Copyright (c) 2019 Endocrine Society. FAU - Gerards, Judith AU - Gerards J AD - Endokrinologie in Charlottenburg, Berlin, Germany. FAU - Heinrich, Daniel A AU - Heinrich DA AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. FAU - Adolf, Christian AU - Adolf C AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. FAU - Meisinger, Christa AU - Meisinger C AD - Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Center of Environmental Health, Neuherberg, Germany. FAU - Rathmann, Wolfgang AU - Rathmann W AD - Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany. AD - German Center for Diabetes Research, Munich-Neuherberg, Germany. FAU - Sturm, Lisa AU - Sturm L AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. FAU - Nirschl, Nina AU - Nirschl N AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. FAU - Bidlingmaier, Martin AU - Bidlingmaier M AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. FAU - Beuschlein, Felix AU - Beuschlein F AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. AD - Klinik fur Endokrinologie, Diabetologie und Klinische Ernahrung, Universitatsspital Zurich, Zurich, Switzerland. FAU - Thorand, Barbara AU - Thorand B AD - Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Center of Environmental Health, Neuherberg, Germany. AD - German Center for Diabetes Research, Munich-Neuherberg, Germany. FAU - Peters, Annette AU - Peters A AD - Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Center of Environmental Health, Neuherberg, Germany. AD - German Center for Diabetes Research, Munich-Neuherberg, Germany. FAU - Reincke, Martin AU - Reincke M AD - Medizinische Klinik und Poliklinik IV, Klinikum der Universitat Munchen, Munich, Germany. FAU - Roden, Michael AU - Roden M AD - German Center for Diabetes Research, Munich-Neuherberg, Germany. AD - Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany. AD - Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany. FAU - Quinkler, Marcus AU - Quinkler M AD - Endokrinologie in Charlottenburg, Berlin, Germany. LA - eng GR - 694913/ERC_/European Research Council/International PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Clin Endocrinol Metab JT - The Journal of clinical endocrinology and metabolism JID - 0375362 RN - IY9XDZ35W2 (Glucose) RN - WI4X0X7BPJ (Hydrocortisone) SB - IM CIN - J Clin Endocrinol Metab. 2020 Mar 1;105(3):. PMID: 31675417 CIN - J Clin Endocrinol Metab. 2020 Mar 1;105(3):. PMID: 31675419 MH - Adult MH - Aged MH - Diabetes Mellitus, Type 2/etiology MH - Female MH - Glucose/*metabolism MH - Glucose Tolerance Test MH - Humans MH - Hydrocortisone/*blood MH - Hyperaldosteronism/complications/*metabolism MH - Insulin Resistance MH - Male MH - Middle Aged EDAT- 2019/03/14 06:00 MHDA- 2020/05/21 06:00 CRDT- 2019/03/14 06:00 PHST- 2019/02/05 00:00 [received] PHST- 2019/03/07 00:00 [accepted] PHST- 2019/03/14 06:00 [pubmed] PHST- 2020/05/21 06:00 [medline] PHST- 2019/03/14 06:00 [entrez] AID - 5374695 [pii] AID - 10.1210/jc.2019-00299 [doi] PST - ppublish SO - J Clin Endocrinol Metab. 2019 Aug 1;104(8):3192-3202. doi: 10.1210/jc.2019-00299.