The Incidence Of Proteinuria And Metabolism In Primary Aldosteronism Patients

Objective:To investigate the difference of proteinuria between primary aldosteronism (PA) and essential hypertension (EH). To explore the risk factors for proteinuria and metabolic syndrome (MS) in PA patients. To analyze the proteinuria in aldosterone-producing adenoma(APA) patients. Methods:155cases of PA and246cases of EH in the hypertension department of the peoplel’s hospital of Xinjiang Uygur autonomous region were recruited in the study. We compared the clinical characterstics and the prevelence of proteinuria between two groups. Furthermor, we analysis the potential risk factors of PA patients by multivariate linear regression model. MS prevalence was observed in216patients with PA hospitalized to our hospital. Data of32APA patients who were confirmed by postoperative pathological diagnose were collected in the hypertension department of the people’s hospital of Xinjiang Uygur autonomous region. The patients were divided into three groups acording to the tertile of serum aldosterone concentration.The24h-urine protein level of three groups were compared. Furthermore, the relationship between24h-urine protein level and serum aldosterone concentration were analyzed. Results:(1)The incidence of proteinuria of PA group was significatly higher than EH group (14.2%vs6.5%, P<0.01). Logistic regression showed that the difference was statistically significant after adjusting age, severity and duration of hypertension (P=0.031). In the PA group, the serum aldosterone level was the risk factor of proteinuria after adjusting age, severity and duration of hypertension and plasma renin levels.(2)The prevalence of MS was47.69%in PA. As the individual components of MS, the prevalence of overweight/obesity, high triglyceride (TG), impaired glucose regulation (IGR), low high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus (DM) was51.13%,22.52%,19.62%,3.82%and2.94%, respectively. The first combination style of MS was overweight/obesity+high TG; the second was overweight/obesity+low HDL-C; the third was overweight/obesity+DM. The prevalence of overweight/obesity and IGR was gradually advance by the plasma aldosteron concentration. The prevalence of MS in Han PA patients(45.3%) was significantly lower than in Uygur (64.0%) but higher than in Kazakh (42.9%)(all P<0.05).(3) Compared with the patients in the first[Lg(24h-urine protein level):0.87±0.28g/24h] and the second group[Lg(24h-urine protein level):1.09±0.27g/24h], the patients in the third group[Lg(24h-urine protein level):1.51±0.50g/24h] had higher24-proteinuria levels (P<0.05). the Pearson correlation analysis showed that24-hour urine protein level was remarkably positively correlated with the serum aldosterone concentration in APA patients.(r=-0.491, P<0.01). Conclusions:The incidence of proteinuria was higher in PA patients and the increased serum aldosterone was the major pathogenic factor. The prevalence of MS with PA was high. The prevalence of MS and the individual components of it were gradually advance by the plasma aldosteron concentration. The prevalence of MS in Han PA patients was lower than in Uygur but higher than in Kazakh. The proteinuria of the APA patients was positively correlated with the serum aldosterone concentration.