Effects of aldosterone on insulin sensitivity and secretion
Open accessAbstract
Dr. Conn originally reported an increased risk of diabetes in patients with hyperaldosteronism in the 1950’s, although the mechanism remains unclear. Aldosterone-induced hypokalemia was initially described to impair glucose tolerance by impairing insulin secretion. Correction of hypokalemia by potassium supplementation only partially restored insulin secretion and glucose tolerance, however. Aldosterone also impairs glucose-stimulated insulin secretion in isolated pancreatic islets via reactive oxygen species in a mineralocorticoid receptor-independent manner. Aldosterone-induced mineralocorticoid receptor activation also impairs insulin sensitivity in adipocytes and skeletal muscle. Aldosterone may produce insulin resistance secondarily by altering potassium, increasing inflammatory cytokines, and reducing beneficial adipokines such as adiponectin. Renin-angiotensin system antagonists reduce circulating aldosterone concentrations and also the risk of type 2 diabetes in clinical trials. These data suggest that primary and secondary hyperaldosteronism may contribute to worsening glucose tolerance by impairing insulin sensitivity or insulin secretion in humans. Future studies should define the effects of MR antagonists and aldosterone on insulin secretion and sensitivity in humans.
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Reduced insulin sensitivity has been reported in patients with primary aldosteronism when they are compared with normotensive cohorts.
“However, when compared with normotensive cohorts, reduced insulin sensitivity has been reported in PA patients [19,9,20,13,8,21,22].”
From Insulin sensitivity and pancreatic β-cell function in patients with primary aldosteronism (2021) · cites this paper as [9]
Section 3.1 reports reduced insulin sensitivity in patients with primary aldosteronism in some studies, but not all. Its comparison is with hypertensive controls, not normotensive cohorts; the separate finding in normotensive subjects concerns an association between aldosterone levels and insulin sensitivity. No page number is available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPrimary aldosteronism is associated with an increased risk of dysglycemia.
“Primary aldosteronism (PA) is associated with increased risk for dysglycemia.”
From Insulin sensitivity and pancreatic β-cell function in patients with primary aldosteronism (2021) · cites this paper as [9]
The effects of hyperaldosteronism on insulin sensitivity and β-cell function are unclear.
“However, the effects of hyperaldosteronism on insulin sensitivity and β-cell function are unclear.”
From Insulin sensitivity and pancreatic β-cell function in patients with primary aldosteronism (2021) · cites this paper as [9]
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Aldosterone and Vascular Mineralocorticoid Receptors
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Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion
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Aldosterone, Renin, and Diabetes Mellitus in African Americans: The Jackson Heart Study
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Aldosterone in gynecology and its involvement on the risk of hypertension in pregnancy
Sabbadin, C., Andrisani, A., Ambrosini, G., Bordin, L., Donà, G., Manso, J., Ceccato, F., Scaroni, C., & Armanini, D. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00575 · Cited by 22 · see citing works
Insulin sensitivity and pancreatic β-cell function in patients with primary aldosteronism
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“Oxidative stress is known to impair insulin metabolic signaling [9].”
BackgroundEvaluation of insulin sensitivity and secretion in primary aldosteronism
Watanabe, D., Yatabe, M., & Ichihara, A. (2016) · Clinical and Experimental Hypertension · doi:10.1080/10641963.2016.1182176 · Cited by 16 · see citing works
- Authors
- Luther, J. M.
- Affiliations
- Vanderbilt University (US)
- Corresponding author
- Luther, James M.
- ORCID
- Luther, James M.
- Venue
- Steroids
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 91
- Pages
- 54-60
- ISSN
- 0039-128X (ISSN-L)
- PMC
- PMC4252580
- OpenAlex
- W2000737837
- Semantic Scholar
- d8cae0905d30138ad7b4829211e70247d81652fc
- Cited by
- 114
- References
- 120
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 10 · 2023: 16 · 2022: 11 · 2021: 10 · 2020: 13 · 2019: 10 · 2018: 10 · 2017: 2 · 2016: 10 · 2015: 4 · 2014: 1
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Steroids (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (DK081662, DK096994)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Keywords
- aldosterone, hyperaldosteronism, insulin sensitivity, insulin secretion, glucose tolerance, insulin resistance, hypokalemia, potassium supplementation, glucose-stimulated insulin secretion, pancreatic islets, reactive oxygen species, mineralocorticoid receptor, adipocytes, skeletal muscle, adiponectin, inflammatory cytokines, renin-angiotensin system inhibitors, type 2 diabetes
- MeSH terms
- Insulin Secretion, Aldosterone, Clinical Trials as Topic, Diabetes Mellitus, Type 2, Humans, Insulin, Insulin Resistance, Models, Biological
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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