Cited by 112Hormonal Regulation and HypertensionAdrenal Hormones and DisordersAdrenal and Paraganglionic Tumors

Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion

Open access
Gerards, Judith, Heinrich, Daniel A, Adolf, Christian, Meisinger, Christa, Rathmann, Wolfgang, Sturm, Lisa, Nirschl, Nina, Bidlingmaier, Martin +6 more·2019·The Journal of Clinical Endocrinology & Metabolism

Abstract

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.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1210/jc.2019-00299

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Gerards, J., Heinrich, D. A., Adolf, C., Meisinger, C., Rathmann, W., Sturm, L., Nirschl, N., Bidlingmaier, M., Beuschlein, F., Thorand, B., Peters, A., Reincke, M., Roden, M., & Quinkler, M.
Affiliations
  • Endokrinologie in Charlottenburg, Berlin, Germany
  • LMU Klinikum (DE)
  • Helmholtz Munich (DE)
  • Deutsches Diabetes-Zentrum e.V. (DE)
  • Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
Corresponding author
Quinkler, Marcus
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2019-03-13
Volume
104
Issue
8
Pages
3192-3202
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W2922008461
Cited by
112
References
49
Citations by year
2026: 8 · 2025: 18 · 2024: 15 · 2023: 15 · 2022: 17 · 2021: 14 · 2020: 16 · 2019: 9
FWCI
11.40
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
  • Site cant be reached (submittedVersion, cc-by)
  • PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
  • OPUS (Augsburg University) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
  • Else Kröner-Fresenius-Stiftung (2013_A182 and 2015_A171)
  • European Research Council (694913)
  • Deutsche Forschungsgemeinschaft (CRC/Transregio 205/1)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
Keywords
primary aldosteronism, autonomous cortisol secretion, hypercortisolism, impaired glucose homeostasis, type 2 diabetes, insulin resistance, dexamethasone suppression test, late-night salivary cortisol, urinary free cortisol, oral glucose tolerance test, cardiovascular risk
MeSH terms
Adult, Aged, Diabetes Mellitus, Type 2, Female, Glucose, Glucose Tolerance Test, Humans, Hydrocortisone, Hyperaldosteronism, Insulin Resistance, Male, Middle Aged

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.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review