Aldosterone excess may inhibit insulin secretion: A comparative study on glucose metabolism pre- and post-adrenalectomy in patients with primary aldosteronism
Open accessAbstract
Conflicting data have been published on the effects of aldosterone excess on glucose metabolism. Specifically, there are limited data on whether adrenalectomy in patients with aldosterone-producing adenomas (APA) can improve glucose metabolism. In this study we evaluated changes in glucose metabolism, before and after surgery for APA. The subjects were 61 patients treated with unilateral adrenalectomy, localized by adrenal venous sampling. A 75g-oral glucose tolerance test (OGTT) was performed before and 1 year after adrenalectomy. Patients with diabetes mellitus or a serum cortisol level >3 μg/dL after a 1 mg dexamethasone suppression test, were excluded. Using the 75g-OGTT data, insulin secretion and insulin resistance (or sensitivity) indices were calculated. The results showed that immunoreactive insulin levels during the OGTT increased significantly after adrenalectomy, whereas plasma glucose levels, before and after surgery, were comparable. The insulinogenic index significantly increased after surgery (0.5 [0.4-0.8] to 0.8 [0.4-1.1], p < 0.001). The disposition index remained largely unchanged (806.2 [489.4-1,138.9] to 686.6 [479.4-922.1], p = 0.25). The homeostatic model assessment of insulin resistance increased significantly (1.0 [0.6-1.5] to 1.5 [1.0-2.2], p < 0.001) and the ISImatsuda decreased significantly (6.9 [4.5-10.4] to 5.2 [3.4-7.9], p < 0.001). Changes in these indices were not correlated with changes in potassium and aldosterone levels before and after surgery. In conclusion, insulin secretion increased after adrenalectomy for APA, indicating that aldosterone excess inhibits insulin secretion. However, because of a parallel increase in insulin resistance, plasma glucose levels remained unchanged.
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Cites
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502 · see citing works
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc11-s062 · Cited by 14,019 · see citing works
Diagnosis and classification of diabetes mellitus
American Diabetes Association (2014) · Diabetes Care · doi:10.2337/dc14-s081 · Cited by 5,974 · see citing works
Matsuda, M., & DeFronzo, R. A. (1999) · Diabetes Care · doi:10.2337/diacare.22.9.1462 · Cited by 5,621 · see citing works
Report of the Committee on the Classification and Diagnostic Criteria of Diabetes Mellitus
Seino, Y., Nanjo, K., Tajima, N., Kadowaki, T., Kashiwagi, A., Araki, E., Ito, C., Inagaki, N., Iwamoto, Y., Kasuga, M., et al. (2010) · Journal of Diabetes Investigation · doi:10.1111/j.2040-1124.2010.00074.x · Cited by 1,780 · see citing works
Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism
Milliez, P., Girerd, X. J., Plouin, P., Blacher, J., Safar, M. E., & Mourad, J. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.01.015 · Cited by 1,541 · see citing works
Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity.
Stümvoll, M., Mitrakou, A., Pimenta, W. P., Jenssen, T. G., Yki-Järvinen, H., van Haeften, T. W., Renn, W., & Gerich, J. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.3.295 · Cited by 1,040 · see citing works
Laakso, M., Edelman, S. V., Brechtel, G., & Baron, A. D. (1990) · Journal of Clinical Investigation · doi:10.1172/jci114644 · Cited by 930 · see citing works
The Diagnosis and Differential Diagnosis of Cushing’s Syndrome and Pseudo-Cushing’s States
Newell-Price, J., Trainer, P., Besser, M., & Grossman, A. (1998) · Endocrine Reviews · doi:10.1210/edrv.19.5.0346 · Cited by 833 · see citing works
Phillips, D. I. W., Clark, P. M., Hales, C. N., & Osmond, C. (1994) · Diabetic Medicine · doi:10.1111/j.1464-5491.1994.tb00273.x · Cited by 631 · see citing works
Cardiovascular Outcomes in Patients With Primary Aldosteronism After Treatment
Catena, C. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.33 · Cited by 566 · see citing works
Nishikawa, T., Omura, M., Satoh, F., Shibata, H., Takahashi, K., Tamura, N., & Tanabe, A. (2011) · Endocrine Journal · doi:10.1507/endocrj.ej11-0133 · Cited by 535 · see citing works
Self-citationRegulation of insulin secretion: a matter of phase control and amplitude modulation
Henquin, J. C. (2009) · Diabetologia · doi:10.1007/s00125-009-1314-y · Cited by 493 · see citing works
Impaired Insulin-Mediated Skeletal Muscle Blood Flow in Patients With NIDDM
Laakso, M., Edelman, S. V., Brechtel, G., & Baron, A. D. (1992) · Diabetes · doi:10.2337/diab.41.9.1076 · Cited by 470 · cited 1× · see citing works
“Skeletal muscle insulin-mediated glucose uptake is equal to the product of arteriovenous glucose difference across and blood flow into muscle [25, 26].”
BackgroundBorn-Frontsberg, E., Reincke, M., Rump, L. C., Hahner, S., Diederich, S., Lorenz, R. L., Allolio, B., Seufert, J., Schirpenbach, C., Beuschlein, F., et al. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-2116 · Cited by 262 · see citing works
Insulin Sensitivity in Patients with Primary Aldosteronism: A Follow-Up Study
Catena, C., Lapenna, R., Baroselli, S., Nadalini, E., Colussi, G., Novello, M., Favret, G., Melis, A., Cavarape, A., & Sechi, L. A. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0736 · Cited by 262 · see citing works
Giacchetti, G., Ronconi, V., Turchi, F., Agostinelli, L., Mantero, F., Rilli, S., & Boscaro, M. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3280108e6f · Cited by 196 · see citing works
Omura, M., Sasano, H., Saito, J., Yamaguchi, K., Kakuta, Y., & Nishikawa, T. (2006) · Hypertension Research · doi:10.1291/hypres.29.883 · Cited by 141 · see citing works
Self-citationOmura, M., Sasano, H., Fujiwara, T., Yamaguchi, K., & Nishikawa, T. (2002) · Metabolism · doi:10.1053/meta.2002.30498 · Cited by 139 · see citing works
Self-citationAldosterone decreases glucose-stimulated insulin secretion in vivo in mice and in murine islets
Luther, J. M., Luo, P., Kreger, M. T., Brissova, M., Dai, C., Whitfield, T. T., Kim, H. S., Wasserman, D. H., Powers, A. C., & Brown, N. J. (2011) · Diabetologia · doi:10.1007/s00125-011-2158-9 · Cited by 109 · see citing works
Aldosterone excess impairs first phase insulin secretion in primary aldosteronism
Fischer, E., Adolf, C., Pallauf, A., Then, C., Bidlingmaier, M., Beuschlein, F., Seissler, J., & Reincke, M. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-3934 · Cited by 88 · cited 4× · see citing works
“showed that adrenalectomy for APA (n = 9) did not affect the index of insulin resistance, assessed using the insulin clamp method [7].”
BackgroundMethodInfluentialInsulin action in primary hyperaldosteronism before and after surgical or pharmacological treatment
Šindelka, G., Widimsky, J., Jr., Haas, T., Prázný, M., Hilgertová, J., & Škrha, J. (2012) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0032-1329211 · Cited by 74 · see citing works
Kitamoto, T., Suematsu, S., Yamazaki, Y., Nakamura, Y., Sasano, H., Matsuzawa, Y., Saito, J., Omura, M., & Nishikawa, T. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-3284 · Cited by 70 · see citing works
Self-citationAldosterone induces clonal β-cell failure through glucocorticoid receptor
Chen, F., Liu, J., Wang, Y., Wu, T., Shan, W., Zhu, Y., & Han, X. (2015) · Scientific Reports · doi:10.1038/srep13215 · Cited by 31 · see citing works
Soyama, A., Nishikawa, T., Ishizuka, T., Itô, H., Saito, J., Kazuo, Y. A. G. I., & Saitō, Y. (2005) · Endocrine Journal · doi:10.1507/endocrj.52.229 · Cited by 31 · see citing works
Self-citation[Screening tests and diagnostic examinations of hypertensives for primary aldosteronism].
Omura, M., & Nishikawa, T. (2006) · PubMed · Cited by 23 · see citing works
Self-citationSato, Y., Oka, R., Nakasone, Y., Katakura, M., Yamauchi, K., & Aizawa, T. (2015) · Endocrine Journal · doi:10.1507/endocrj.ej15-0122 · Cited by 5 · see citing works
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Impaired Glucose Metabolism in Primary Aldosteronism Is Associated With Cortisol Cosecretion
Gerards, J., Heinrich, D. A., Adolf, C., Meisinger, C., Rathmann, W., Sturm, L., Nirschl, N., Bidlingmaier, M., Beuschlein, F., Thorand, B., et al. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2019-00299 · Cited by 112 · see citing works
Primary aldosteronism decreases insulin secretion and increases insulin clearance in humans
Adler, G. K., Murray, G. R., Turcu, A. F., Nian, H., Yu, C., Solorzano, C. C., Manning, R., Peng, D., & Luther, J. M. (2020) · Hypertension · doi:10.1161/hypertensionaha.119.13922 · Cited by 71 · see citing works
“Consistent with our findings, a Japanese cohort demonstrated reduced glucose tolerance and insulin secretion during glucose tolerance tests but increased insulin sensitivity during hyperinsulinemic clamps in patients with primary aldosteronism,(37) and an additional group similarly demonstrated reduced insulin sensiti…”
ResultHan, M., Cao, X., Zhao, C., Yang, L., Yin, N., Shen, P., Zhang, J., Gao, F., Ren, Y., Liang, D., et al. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.544752 · Cited by 10 · see citing works
- Authors
- Tsurutani, Y., Sugisawa, C., Ishida, A., Inoue, K., Saito, J., Omura, M., Nagasaka, S., & Nishikawa, T.
- Affiliations
- Yokohama Rosai Hospital (JP)
- SHOWA Medical University Fujigaoka Hospital (JP)
- ORCID
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2017
- Volume
- 64
- Issue
- 3
- Pages
- 339-346
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W2577783334
- Semantic Scholar
- 491a9b51d98bbd126308eabd99882d67a97bb26c
- Cited by
- 32
- References
- 27
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 10 · 2019: 8 · 2018: 1
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health, Labour and Welfare
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- primary aldosteronism, aldosterone excess, insulin secretion, insulin resistance, adrenalectomy, aldosterone-producing adenoma, glucose metabolism, insulinogenic index, disposition index, HOMA, oral glucose tolerance test
- MeSH terms
- Insulin Secretion, Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aldosterone, Blood Glucose, Female, Glucose Tolerance Test, Humans, Hyperaldosteronism, Insulin, Insulin Resistance, Japan, Male, Middle Aged, Postoperative Period, Potassium, Retrospective Studies, Adrenocortical Adenoma, Insulin-Secreting Cells, Preoperative Period
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