Korean Circ J.  2018 Mar;48(3):198-208. 10.4070/kcj.2017.0200.

Independent Association of Serum Aldosterone Level with Metabolic Syndrome and Insulin Resistance in Korean Adults

• Min SH
• Kim SH
• Jeong IK
• Cho HC
• Jeong JO
• Lee JH
• Kang HJ
• Kim HS
• Park KS
• Lim S

• KMID: 2406923
• DOI: http://doi.org/10.4070/kcj.2017.0200

Abstract

BACKGROUND AND OBJECTIVES
A relationship between renin-angiotensin system (RAS) components and metabolic syndrome (MetS) has been suggested, but not elucidated clearly. We examined the levels of RAS components in patients with and without MetS and their association with MetS in Korean population.
METHODS
This study was approved by the review boards of the participating institutions and endorsed by the Korean Society of Lipid and Atherosclerosis. We screened 892 Koreans aged ≥20 years who underwent evaluation of hypertension, diabetes, or dyslipidemia at 6 tertiary hospitals in 2015-2016. After excluding patients who were taking diuretics, β-blockers, or RAS blockers, or suspected of primary aldosteronism, 829 individuals were enrolled. Anthropometric and biochemical parameters including aldosterone, plasma renin activity (PRA), and aldosterone-to-PRA ratio were evaluated. The homeostasis model assessment for insulin resistance (HOMA-IR) were used for evaluating insulin resistance.
RESULTS
The mean age of the participants was 52.8±12.8 years, 56.3% were male, and their mean systolic and diastolic blood pressures were 133.9±20.0 and 81.2±14.6 mmHg, respectively. The levels of serum aldosterone, but not PRA, were significantly higher in subjects with MetS than in those without (20.6±33.6 vs. 15.3±12.2 ng/dL, p < 0.05), and positively correlated with waist circumference, blood pressure, triglycerides, and glycated hemoglobin. The levels of aldosterone were independently associated with the number of MetS components and HOMA-IR after adjusting for conventional risk factors.
CONCLUSIONS
Serum aldosterone levels were higher in Korean adults with MetS than in those without. This finding suggests that increased aldosterone level might be closely associated with insulin resistance.

Keyword

Aldosterone; Metabolic syndrome X; Insulin resistance

MeSH Terms

Adult*
Aldosterone*
Atherosclerosis
Blood Pressure
Diuretics
Dyslipidemias
Hemoglobin A, Glycosylated
Homeostasis
Humans
Hyperaldosteronism
Hypertension
Insulin Resistance*
Insulin*
Male
Metabolic Syndrome X
Plasma
Renin
Renin-Angiotensin System
Risk Factors
Tertiary Care Centers
Triglycerides
Waist Circumference
Aldosterone
Diuretics
Insulin
Renin
Triglycerides

Figure

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  Figure 1 Flow chart showing enrollment of patients. PRA, plasma renin activity.

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  Figure 2 Mean (SD) serum aldosterone levels according to the presence (+) or absence (−) of MetS. MetS, metabolic syndrome; SD, standard deviation. *p<0.05.

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