DataSheet_1_Differences in Glycemic Abnormalities Between Primary Aldosteronism and Essential Hypertension: A Systematic Review and Meta-Analysis.docx

BackgroundThe relationship of glycemic abnormalities between primary aldosteronism (PA) patients and essential hypertension (EH) patients is still debatable. This meta-analysis aimed to explore differences in the prevalence of glycemic abnormalities and levels of abnormal glucose metabolism in PA and EH patients.MethodsA search was performed using PubMed, Scopus, Cochrane and Web of Science databases from their inception through January 2022. Inclusion criteria for this study were 1) observational studies which contained specific data of interest, 2) studies including data which compared adult PA and EH patients and 3) studies which used appropriate methods to diagnose PA. Risk ratio (RR) or standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated.ResultsTwenty-six studies involving 53,186 patients were included in the meta-analysis. Patients with PA demonstrated significantly higher overall incidence of glycemic abnormalities than patients with EH [RR 1.54; 95% CI (1.20,1.98)]. Risk of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in PA patients were higher than in EH patients [RR 1.27; 95%CI (1.08, 1.49) and RR 2.99; 95%CI (1.74, 5.16), respectively]. There was no statistically significant difference of risk between these groups for impaired fasting glucose (IFG) [RR 1.70; 95%CI (0.55, 5.26)]. Moderate heterogeneity was observed in overall glycemic abnormalities outcomes. A high level of heterogeneity was observed for IFG, while the level was low for DM and IGT.ConclusionsPA patients have a higher risk of glycemic abnormalities than in EH patients. Further study should be conducted to investigate underlying mechanisms of glycemic abnormalities in PA.Systematic Review Registrationwww.inplasy.com, INPLASY, identifier 202220004.

背景：原发性醛固酮增多症（PA）患者与原发性高血压（EH）患者之间血糖异常的相关性尚存在争议。本项荟萃分析旨在探讨PA和EH患者中血糖异常的患病率和异常葡萄糖代谢水平的差异。方法：通过PubMed、Scopus、Cochrane和Web of Science数据库自创立至2022年1月进行检索。本研究的纳入标准包括：1）包含感兴趣特定数据的观察性研究，2）包括比较成人PA和EH患者数据的调查，以及3）采用适当方法诊断PA的研究。计算了风险比（RR）或标准化均数差（SMD）及其95%置信区间（95%CI）。结果：26项涉及53,186名患者的临床研究被纳入荟萃分析。与EH患者相比，PA患者的总体血糖异常发生率显著更高[RR 1.54；95%CI（1.20，1.98）]。PA患者发生糖尿病（DM）和葡萄糖耐量受损（IGT）的风险高于EH患者[RR 1.27；95%CI（1.08，1.49）和RR 2.99；95%CI（1.74，5.16）]，而对于空腹血糖受损（IFG），两组间风险差异无统计学上的显著性[RR 1.70；95%CI（0.55，5.26）]。总体血糖异常结果存在中等异质性。IFG结果的异质性较高，而DM和IGT的异质性水平较低。结论：PA患者的血糖异常风险高于EH患者。应进一步开展研究以探究PA患者血糖异常的潜在机制。系统评价注册：www.inplasy.com，INPLASY，注册号202220004。