Unilateral primary aldosteronism as an independent risk factor for vertebral fracture
Funding information
This work was supported by Kyushu University Research Activity Support Program, Support for Women Returning from Maternity and Parental Leave.
Abstract
Context
Primary aldosteronism (PA) is known to increase vertebral fracture (VF), although the detailed mechanism remains to be elucidated. We hypothesized that the PA subtype is associated with VF.
Objective
To evaluate whether unilateral PA is associated with the prevalence of VF.
Design
This was a retrospective cross-sectional study in a single referral centre.
Patients
We identified 210 hypertensive patients whose clinical data were available for case-detection results. One hundred and fifty-two patients were diagnosed with PA using captopril challenge tests.
Measurements
We measured the prevalence of VF, according to PA subtype.
Results
One hundred thirteen patients with PA were subtype classified by adrenal vein sampling. Of these, 37 patients had unilateral PA, 76 patients had bilateral PA, 58 patients had non-PA; 39 patients with PA were not subtype-classified. Patients with PA had a higher prevalence of VF (29%, 44/152) than those with non-PA (12%, 7/58; P = .011). Moreover, unilateral PA had a higher prevalence of VF (46%, 17/37) than bilateral PA (20%, 15/76; P = .021). There was no significant difference in the prevalence of VF between bilateral PA and non-PA. Unilateral PA was an independent risk factor for VF after adjusting for age and sex (OR: 3.16, 95% confidence interval: 1.12-8.92; P = .017). Among patients with unilateral PA, serum cortisol concentrations after 1-mg dexamethasone suppression test were higher in those with VF (1.32 ± 0.67 g/dL) than those without (0.96 ± 0.33 g/dL; P = .048).
Conclusions
Unilateral PA is an independent risk factor for VF.
CONFLICTS OF INTEREST
The author reports no conflicts of interest in this work.
Open Research
DATA AVAILABILITY STATEMENT
The data sets generated during and analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.
