Diabetes mellitus itself increases cardio-cerebrovascular risk and renal complications in primary aldosteronism.

CONTEXT: The prevalence of diabetes mellitus (DM) in patients with primary aldosteronism (PA) is higher than in those with essential hypertension and the general population. Although DM is a common major risk factor for the cardio-cerebrovascular (CCV) diseases and renal complications, details of its effects in PA have not been demonstrated. OBJECTIVE: The aim of this study was to determine the effects of co-existent DM on the risk of CCV events and progression of renal complications in PA patients. DESIGN: Multi-institutional cross-sectional study. PATIENTS AND METHODS: PA patients experienced between January 2006 and October 2016 and with available data of CCV events and DM were enrolled from the Japan PA registry of the JPAS/JRAS (n=2,524). CCV events and renal complications were compared between DM group and non-DM group by logistic and liner-regression analysis. RESULTS: DM significantly increased the odds ratio of CCV events (OR 1.59, 95% CI: 1.05-2.41) and that of proteinuria (OR 2.25, 95% CI: 1.59-3.16). DM correlated significantly with the declines in eGFR (beta=0.05, p=0.02). CONCLUSIONS: This the first report to demonstrate the presence of DM as an independent risk factor for CCV events and renal complications even in PA patients. Management of DM should be considered in addition to the specific treatment of PA.