Sex Difference in the Association Between Subtype Distribution and Age at Diagnosis in Patients With Primary Aldosteronism

被引：29

作者：

Akasaka, Hiroshi ^{[1
]}

Yamamoto, Koichi ^{[1
]}

Rakugi, Hiromi ^{[1
]}

Nagasawa, Motonori ^{[1
]}

Nakamaru, Ryo ^{[1
]}

Ichijo, Takamasa ^{[2
]}

Takeda, Yoshiyu ^{[3
]}

Kurihara, Isao ^{[4
]}

Katabami, Takuyuki ^{[5
]}

Tsuiki, Mika ^{[6
]}

Wada, Norio ^{[7
]}

Ogawa, Yoshihiro ^{[8
]}

Kawashima, Junji ^{[9
]}

Sone, Masakatsu ^{[10
]}

Kamemura, Kohei ^{[11
]}

Yoshimoto, Takanobu ^{[12
]}

Matsuda, Yuichi ^{[13
]}

Fujita, Megumi ^{[14
]}

Kobayashi, Hiroki ^{[15
]}

Watanabe, Minemori ^{[16
]}

Tamura, Kouichi ^{[17
]}

Okamura, Shintaro ^{[18
]}

Miyauchi, Shozo ^{[19
]}

Izawa, Shoichiro ^{[20
]}

Chiba, Yoshiro ^{[21
]}

Tanabe, Akiyo ^{[22
]}

Naruse, Mitsuhide ^{[6
]}

机构：

[1] Osaka Univ, Dept Geriatr & Gen Med, Grad Sch Med, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan

[2] Saiseikai Yokohama Tobu Hosp, Dept Endocrinol & Diabet, Yokohama, Kanagawa, Japan

[3] Kanazawa Univ, Grad Sch Med Sci, Dept Hlth Promot & Med Future, Kanazawa, Ishikawa, Japan

[4] Keio Univ, Sch Med, Dept Endocrinol Metab & Nephrol, Tokyo, Japan

[5] St Marianna Univ, Div Endocrinol & Metab, Dept Internal Med, Sch Med,Yokohama City Seibu Hosp, Kawasaki, Kanagawa, Japan

[6] Natl Hosp Org Kyoto Med Ctr, Div Endocrinol & Metab, Kyoto, Japan

[7] Sapporo City Gen Hosp, Dept Endocrinol & Diabet, Sapporo, Hokkaido, Japan

[8] Kyushu Univ, Grad Sch Med Sci, Dept Med & Bioregulatory Sci, Fukuoka, Fukuoka, Japan

[9] Kumamoto Univ, Dept Metab Med, Fac Life Sci, Kumamoto, Japan

[10] Kyoto Univ, Grad Sch Med, Dept Diabet Endocrinol & Nutr, Kyoto, Japan

[11] Shinko Hosp, Dept Cardiol, Kobe, Hyogo, Japan

[12] Tokyo Med & Dent Univ, Dept Mol Endocrinol & Metab, Grad Sch Med, Tokyo, Japan

[13] Sanda City Hosp, Dept Cardiol, Sanda, Japan

[14] Univ Tokyo, Grad Sch Med, Div Nephrol & Endocrinol, Tokyo, Japan

[15] Nihon Univ, Sch Med, Div Nephrol Hypertens & Endocrinol, Tokyo, Japan

[16] Okazaki City Hosp, Dept Endocrinol & Diabet, Okazaki, Aichi, Japan

[17] Yokohama City Univ, Grad Sch Med, Dept Med Sci & Cardiorenal Med, Yokohama, Kanagawa, Japan

[18] Tenri Yorozu Hosp, Dept Endocrinol, Tenri, Nara, Japan

[19] Ehime Prefectural Cent Hosp, Dept Endocrinol & Diabet, Matsuyama, Ehime, Japan

[20] Tottori Univ, Sch Med, Dept Mol Med & Therapeut, Yonago, Tottori, Japan

[21] Mito Saiseikai Gen Hosp, Endovasc Treatment Grp, Mito, Ibaraki, Japan

[22] Natl Ctr Global Hlth & Med, Dept Diabet Endocrinol & Metab, Tokyo, Japan

来源：

HYPERTENSION | 2019年 / 74卷 / 02期

关键词：

aldosterone; body mass index; hyperaldosteronism; hypertension; obesity; BILATERAL PRIMARY ALDOSTERONISM; SOMATIC MUTATIONS; KCNJ5; ADENOMAS; OBESITY; ATP2B3; ATP1A1;

D O I：

10.1161/HYPERTENSIONAHA.119.13006

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Primary aldosteronism (PA) is the most frequent cause of secondary hypertension. Adrenal vein sampling (AVS) is an established method for finding patients with the unilateral subtype of PA, for which adrenalectomy is an applicable treatment. In this study, we analyzed a large database of patients with PA who underwent adrenal vein sampling, to investigate the sex differences in the impact of age at diagnosis on the subtype and cause of PA. In 2122 patients, women with the unilateral subtype were younger than men with the same subtype and women with the bilateral subtype. Younger age and older age were associated with unilateral PA in women and men, respectively. After stratification by tertiles of age, there was a trend of decreased and increased incidence of unilateral PA with aging in women and men, respectively. Male sex was a predictor of unilateral PA in middle-aged and older patients but not in younger patients. We also found that obesity, a known factor associated with idiopathic hyperaldosteronism, was positively associated with bilateral PA in younger patients but not in older patients. These findings suggest that the proportion of operable patients with unilateral PA differs depending on the combination of sex and age, and that other than obesity, the cause of PA is also associated with the bilateral subtype in older patients.

引用

页码：368 / 374

页数：7

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