Table_2_Non-Alcoholic Fatty Liver Disease and Hypokalemia in Primary Aldosteronism Among Chinese Population.docx

BackgroundIn recent years, evidence that aldosteronism is a risk factor for metabolic disorders has increased. This study was designed to investigate the role of nonalcoholic fatty liver disease (NAFLD) and hypokalemia in primary aldosteronism (PA).
MethodsA total of 222 patients diagnosed with PA and 222 non-PA patients were included in our study. Demographic data, medical histories, clinical evaluations, complete blood counts, serum biochemical analyses, aldosterone and potassium levels were obtained. Data are presented as the means ± standard deviation (SD). To compare the parameters between cases and controls, Student’s t-tests or Mann-Whitney U tests were used for continuous variables, and χ2 tests were used for categorical variables. Pearson correlation analysis was used to define relationships between pairs of parameters. A two-sided P < 0.05 was considered statistically significant. Multivariate logistic regression was performed to assess the independent effects of potassium and other metabolic variables on NAFLD in PA patients.
ResultsThe diagnosis of NAFLD was more common in PA patients (n=222, 35.1%) than in non-PA subjects (29.7%). PA patients with and without NAFLD had similar metabolic imbalance characteristics. In PA patients with hypokalemia, relatively higher prevalences of NAFLD (44% vs. 27%, P < 0.05) and diabetes mellitus (19.8% vs. 9.9%, P < 0.05) were observed. Hypokalemic PA patients had a worse metabolic status than PA patients without hypokalemia, including higher body mass index (BMI) (25.4 ± 3.4 vs. 24.1 ± 3.9 kg/m2, P < 0.05), more severe dyslipidemia as well as insulin resistance, higher serum uric acid levels (354 ± 95 vs. 319 ± 87 μmol/L, P < 0.01) and aggravated inflammation.
ConclusionThe prevalence of NAFLD was higher in PA patients than in non-PA patients, although the patterns of obesity, dyslipidemia and insulin resistance were similar. Hypokalemic PA patients had a worse metabolic status than normokalemic PA patients. This study provides new insights that can inform further mechanistic studies about metabolic imbalance in patients with aldosteronism.

研究背景 近年来，醛固酮增多症作为代谢紊乱危险因素的相关证据逐渐增多。本研究旨在探讨非酒精性脂肪性肝病（NAFLD）与低钾血症在原发性醛固酮增多症（PA）中的作用。研究方法 本研究共纳入222例确诊原发性醛固酮增多症（PA）患者与222例非PA对照患者。收集所有受试者的人口学资料、病史、临床评估结果、全血细胞计数、血清生化检测、醛固酮及血钾水平。数据以均值±标准差（standard deviation, SD）形式呈现。为比较病例组与对照组的参数差异，连续变量采用学生t检验（Student’s t-tests）或曼-惠特尼U检验（Mann-Whitney U tests），分类变量采用卡方检验（χ² tests）。采用Pearson相关分析（Pearson correlation analysis）明确参数间的两两关联。以双侧P<0.05为差异具有统计学意义。通过多因素logistic回归分析，评估钾离子及其他代谢变量对PA患者非酒精性脂肪性肝病（NAFLD）的独立影响。研究结果 原发性醛固酮增多症（PA）患者中非酒精性脂肪性肝病（NAFLD）的检出率为35.1%（n=222），高于非PA受试者的29.7%。伴与不伴NAFLD的PA患者，其代谢失衡特征相似。在合并低钾血症的PA患者中，NAFLD（44% vs. 27%，P<0.05）与糖尿病（19.8% vs. 9.9%，P<0.05）的患病率相对更高。合并低钾血症的PA患者代谢状态较血钾正常的PA患者更差，具体表现为：体质量指数（body mass index, BMI）更高（25.4±3.4 vs. 24.1±3.9 kg/m²，P<0.05）、血脂紊乱与胰岛素抵抗程度更严重、血清尿酸水平更高（354±95 vs. 319±87 μmol/L，P<0.01）以及炎症状态更显著。研究结论 尽管肥胖、血脂紊乱及胰岛素抵抗的表型相似，但PA患者的NAFLD患病率高于非PA患者。合并低钾血症的PA患者代谢状态较血钾正常的PA患者更差。本研究为醛固酮增多症患者代谢失衡的后续机制研究提供了新的视角。