Table_1_Evaluation of Abdominal Computed Tomography Scans for Differentiating the Discrepancies in Abdominal Adipose Tissue Between Two Major Subtypes of Primary Aldosteronism.docx

The aim of this study was to analyze the differences in the distribution of abdominal adipose tissue between the two subtypes of primary aldosteronism (PA) using abdominal computed tomography. We retrospectively analyzed patients diagnosed as having essential hypertension (EH) or PA from the prospectively collected Taiwan Primary Aldosteronism Investigation (TAIPAI) database. Patients with PA were divided into the subgroups of idiopathic hyperaldosteronism (IHA) and unilateral aldosterone-producing adenoma (APA). Patients’ basic clinicodemographic data were collected, and a self-developed CT-based software program was used to quantify the abdominal adiposity indexes, including visceral adipose tissue (VAT) area, VAT ratio, waist circumference (WC), subcutaneous adipose tissue (SAT) area, and SAT ratio. We included 190 patients with EH and 436 patients with PA (238 with IHA and 198 with APA). The APA group had significantly lower abdominal adiposity indexes than the other groups. We also found negative correlations of aldosterone-to-renin ratio (ARR) with VAT area, VAT ratio, WC, and body mass index (BMI) in the APA group. After propensity score matching (which left 184 patients each in the IHA and APA groups), patients in the APA group still had significantly lower WC, SAT area, SAT ratio, and VAT ratio than those in the IHA group. Furthermore, logistic regression analysis indicated that lower probability of abdominal obesity was significantly related to patients with APA. Our data revealed that the distribution of abdominal adipose tissue was similar in patients with IHA and those with EH, but the abdominal adiposity indexes were significantly lower in patients with APA than in those with IHA and EH.

本研究旨在利用腹部计算机断层扫描技术，分析原发性醛固酮增多症（PA）两种亚型（即特发性高醛固酮血症（IHA）和单侧醛固酮分泌腺瘤（APA））之间腹部脂肪组织分布的差异。本研究对来自前瞻性收集的台湾原发性醛固酮增多症调查（TAIPAI）数据库中诊断为原发性高血压（EH）或PA的患者进行了回顾性分析。PA患者被分为IHA和APA亚组。收集患者的基本临床人口学数据，并使用自开发的基于CT的软件程序量化腹部脂肪指数，包括内脏脂肪组织（VAT）面积、VAT比率、腰围（WC）、皮下脂肪组织（SAT）面积和SAT比率。共纳入190例EH患者和436例PA患者（其中238例IHA和198例APA）。APA组的腹部脂肪指数显著低于其他组。我们还发现APA组中醛固酮-肾素比（ARR）与VAT面积、VAT比率、WC和体重指数（BMI）呈负相关。经过倾向评分匹配（使得IHA和APA组各剩下184例患者）后，APA组的WC、SAT面积、SAT比率和VAT比率仍显著低于IHA组。此外，逻辑回归分析表明，腹部肥胖的低发生概率与APA患者显著相关。我们的数据揭示，IHA患者与EH患者腹部脂肪组织的分布相似，但APA患者的腹部脂肪指数显著低于IHA和EH患者。