Relationship of plasma aldosterone levels and carbohydrate metabolism in heart failure with preserved ejection fraction
Open Access
- 17 February 2021
- journal article
- Published by Silicea - Poligraf, LLC in Russian Journal of Cardiology
- Vol. 26 (1), 3991
- https://doi.org/10.15829/1560-4071-2021-3991
Abstract
Aim. To determine the relationship between the blood aldosterone levels and parameters of carbohydrate metabolism in patients with heart failure (HF) with preserved ejection fraction (HFpEF).Material and methods. This cross-sectional study included 158 patients with stable HFpEF. HFpEF was established in the presence of symptoms and/or signs of HF, left ventricular ejection fraction >50%, increased blood NT-proBNP levels, and characteristic structural cardiac changes according to echocardiography. The study did not include patients with primary hyperaldosteronism and those taking mineralocorticoid receptor antagonists within the previous 6 weeks. In all patients, the blood aldosterone and carbohydrate metabolism parameters were assessed. The aldosterone levels were determined by the enzyme immunoassay and the concentration of 40-160 pg/ml was considered the reference values. Diabetes was diagnosed in the following cases: history of diabetes, treatment with antidiabetic drugs, blood glucose level ≥7,0 mmol/L in two samples or glycated hemoglobin (HbA1c) >6,5%. Prediabetes was recorded if the blood glucose level in a patient without diabetes was in the range of ≥5,6 mmol/L andResults. In 99 patients (62,7%, group 1), the aldosterone levels were within the normal range, while in the remaining 59 patients (37,3%, group 2), it exceeded the upper limit. Patients with hyperaldosteronemia compared with those with normal aldosterone levels had significantly higher fasting plasma glucose levels (6,60 (6,00-7,90) mmol/L vs 5,80 (5,25-6,80) mmol/L, pnd group more often suffered from diabetes (39,0% vs 19,2%, pst group. Correlation analysis showed a significant relationship between the level of aldosterone and blood glucose (r=0,29), HbA1c (r=0,17) and HOMA (r=0,23) values. After standardization by age, HF class, body mass index, blood pressure, cholesterol and blood potassium levels in multivariate analysis, the presence of hyperaldosteronemia was significantly correlated with diabetes (odds ratio, 1,64, 95% confidence interval, 1,14-3,32, p=0,013) and hyperglycemia (odds ratio, 2,84, 95% confidence interval, 1,94-14,2, p=0,008). Conclusion. The development of secondary hyperaldosteronism in patients with HFpEF is associated with a significant increase in the risk of hyperglycemia and diabetes.Keywords
This publication has 28 references indexed in Scilit:
- Adipocytes Produce Aldosterone Through Calcineurin-Dependent Signaling PathwaysHypertension, 2012
- Diagnosis and Classification of Diabetes MellitusDiabetes Care, 2010
- Elevated glycated haemoglobin is a strong predictor of mortality in patients with left ventricular systolic dysfunction who are not receiving treatment for diabetes mellitusPublished by BMJ ,2009
- Insulin Resistance and Hyperinsulinemia Are Related to Plasma Aldosterone Levels in Hypertensive PatientsDiabetes Care, 2007
- Effect of Inhibition of the Renin-Angiotensin System on Development of Type 2 Diabetes Mellitus (Meta-Analysis of Randomized Trials)The American Journal of Cardiology, 2007
- The physiology of a local renin–angiotensin system in the pancreasJournal Of Physiology-London, 2007
- Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in BlacksHypertension, 2007
- Aldosterone Inhibits Uncoupling Protein-1, Induces Insulin Resistance, and Stimulates Proinflammatory Adipokines in AdipocytesHormone and Metabolic Research, 2005
- The renin–angiotensin–aldosterone system, glucose metabolism and diabetesTrends in Endocrinology & Metabolism, 2005
- Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitusThe American Journal of Cardiology, 2004