Body Mass Index Predicts Aldosterone Production in Normotensive Adults on a High-salt Diet

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2007 Aug 30

PMID 17726083

Citations 112

Authors

Rhonda Bentley-Lewis

Gail K Adler

Todd Perlstein

Ellen W Seely

Paul N Hopkins

Gordon H Williams

Rajesh Garg

Affiliations

Soon will be listed here.

Abstract

Context: The mechanisms underlying obesity-mediated cardiovascular disease are not fully understood. Aldosterone and insulin resistance both are associated with obesity and cardiovascular disease.

Objectives: The objectives of this study were to test the hypotheses that aldosterone production is elevated and associated with insulin resistance in overweight adults on a high-sodium diet.

Participants/interventions: Healthy normotensive adults were categorized as lean body mass index (BMI) less than 25 kg/m(2) (n = 63) or overweight BMI 25 kg/m(2) or greater (n = 57). After 7 d of a high-sodium diet, participants fasted overnight and remained supine throughout hemodynamic and laboratory assessments and angiotensin II (AngII) stimulation.

Results: The overweight group, compared with the lean group, had higher 24-h urinary aldosterone (9.0 +/- 0.8 vs. 6.6 +/- 0.5 microg per 24 h; P = 0.003) and higher AngII-stimulated serum aldosterone (11.4 +/- 1.0 vs. 9.0 +/- 0.6 ng/dl; P = 0.04). There were no differences in 24-h urinary cortisol or sodium or supine measurements of plasma renin activity, serum aldosterone, or serum potassium. The homeostasis model assessment of insulin resistance was predicted by urinary aldosterone excretion (r = 0.32, P = 0.03) and serum aldosterone response to AngII stimulation (r = 0.28, P = 0.02) independent of age and BMI.

Conclusion: Urinary aldosterone excretion and AngII-stimulated aldosterone are increased in overweight, compared with lean, normotensive adults. The correlation of these measures of aldosterone production with insulin resistance suggests a potential role for aldosterone in the pathophysiology of obesity-mediated insulin resistance.

Citing Articles

Characterizing the Origins of Primary Aldosteronism.

Brown J, Honzel B, Tsai L, Milks J, Neibuhr Y, Neibuhr Y Hypertension. 2024; 82(2):306-318.

PMID: 39660429 PMC: 11735322. DOI: 10.1161/HYPERTENSIONAHA.124.24153.

Visceral adiposity as a predictor of new-onset diabetes in patients with primary aldosteronism: a cohort study.

Chu W, Er L, Chang C, Lu J, Wu W, Tsai Y Ther Adv Chronic Dis. 2024; 15:20406223241301892.

PMID: 39619168 PMC: 11607768. DOI: 10.1177/20406223241301892.

Rising Prevalence of Obesity and Primary Hyperaldosteronism: Co-incidence or Connected Circumstances Leading to Hypertension? A Narrative Review.

Bansal S, Puzantian H, Townsend R J Gen Intern Med. 2024; .

PMID: 39414738 DOI: 10.1007/s11606-024-09081-2.

Obesity and hypertension in children and adolescents.

Jeong S, Kim S Clin Hypertens. 2024; 30(1):23.

PMID: 39217385 PMC: 11366140. DOI: 10.1186/s40885-024-00278-5.

Variable effect of the post-partum menstrual cycle on aldosterone and renin in women with recent preeclampsia.

Veldhuizen G, Alnazer R, Kroon A, Spaanderman M, de Leeuw P J Hum Hypertens. 2024; 38(9):649-654.

PMID: 38898171 DOI: 10.1038/s41371-024-00926-1.

References

Goodfriend T, Egan B, Kelley D . Aldosterone in obesity. Endocr Res. 1999; 24(3-4):789-96. DOI: 10.3109/07435809809032689. View

Kidambi S, Kotchen J, Grim C, Raff H, Mao J, Singh R . Association of adrenal steroids with hypertension and the metabolic syndrome in blacks. Hypertension. 2006; 49(3):704-11. DOI: 10.1161/01.HYP.0000253258.36141.c7. View

Van Gaal L, Mertens I, De Block C . Mechanisms linking obesity with cardiovascular disease. Nature. 2006; 444(7121):875-80. DOI: 10.1038/nature05487. View

Goodfriend T, Egan B, Stepniakowski K, Ball D . Relationships among plasma aldosterone, high-density lipoprotein cholesterol, and insulin in humans. Hypertension. 1995; 25(1):30-6. DOI: 10.1161/01.hyp.25.1.30. View

Faloia E, Gatti C, Camilloni M, Mariniello B, Sardu C, Garrapa G . Comparison of circulating and local adipose tissue renin-angiotensin system in normotensive and hypertensive obese subjects. J Endocrinol Invest. 2002; 25(4):309-14. DOI: 10.1007/BF03344010. View

Licata G, Scaglione R, Ganguzza A, Corrao S, Donatelli M, Parrinello G . Central obesity and hypertension. Relationship between fasting serum insulin, plasma renin activity, and diastolic blood pressure in young obese subjects. Am J Hypertens. 1994; 7(4 Pt 1):314-20. DOI: 10.1093/ajh/7.4.314. View

Eckel R, Kahn R, Robertson R, Rizza R . Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. Circulation. 2006; 113(25):2943-6. DOI: 10.1161/CIRCULATIONAHA.106.176583. View

Raji A, Williams J, Hopkins P, Simonson D, Williams G . Familial aggregation of insulin resistance and cardiovascular risk factors in hypertension. J Clin Hypertens (Greenwich). 2006; 8(11):791-6. PMC: 8109457. DOI: 10.1111/j.1524-6175.2006.05761.x. View

Engeli S, Bohnke J, Gorzelniak K, Janke J, Schling P, Bader M . Weight loss and the renin-angiotensin-aldosterone system. Hypertension. 2005; 45(3):356-62. DOI: 10.1161/01.HYP.0000154361.47683.d3. View

10.

Bochud M, Nussberger J, Bovet P, Maillard M, Elston R, Paccaud F . Plasma aldosterone is independently associated with the metabolic syndrome. Hypertension. 2006; 48(2):239-45. DOI: 10.1161/01.HYP.0000231338.41548.fc. View

11.

Rocchini A, Katch V, Grekin R, Moorehead C, Anderson J . Role for aldosterone in blood pressure regulation of obese adolescents. Am J Cardiol. 1986; 57(8):613-8. DOI: 10.1016/0002-9149(86)90845-3. View

12.

Catena C, Lapenna R, Baroselli S, Nadalini E, Colussi G, Novello M . Insulin sensitivity in patients with primary aldosteronism: a follow-up study. J Clin Endocrinol Metab. 2006; 91(9):3457-63. DOI: 10.1210/jc.2006-0736. View

13.

Rader D . Effect of insulin resistance, dyslipidemia, and intra-abdominal adiposity on the development of cardiovascular disease and diabetes mellitus. Am J Med. 2007; 120(3 Suppl 1):S12-8. DOI: 10.1016/j.amjmed.2007.01.003. View

14.

Bergman R, Kim S, Hsu I, Catalano K, Chiu J, Kabir M . Abdominal obesity: role in the pathophysiology of metabolic disease and cardiovascular risk. Am J Med. 2007; 120(2 Suppl 1):S3-8. DOI: 10.1016/j.amjmed.2006.11.012. View

15.

Kosachunhanun N, Hunt S, Hopkins P, Williams R, Jeunemaitre X, Corvol P . Genetic determinants of nonmodulating hypertension. Hypertension. 2003; 42(5):901-8. DOI: 10.1161/01.HYP.0000095615.83724.82. View

16.

Licata G, Volpe M, Scaglione R, Rubattu S . Salt-regulating hormones in young normotensive obese subjects. Effects of saline load. Hypertension. 1994; 23(1 Suppl):I20-4. DOI: 10.1161/01.hyp.23.1_suppl.i20. View

17.

Fallo F, Veglio F, Bertello C, Sonino N, Della Mea P, Ermani M . Prevalence and characteristics of the metabolic syndrome in primary aldosteronism. J Clin Endocrinol Metab. 2005; 91(2):454-9. DOI: 10.1210/jc.2005-1733. View

18.

Tuck M, Sowers J, Dornfeld L, Kledzik G, Maxwell M . The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients. N Engl J Med. 1981; 304(16):930-3. DOI: 10.1056/NEJM198104163041602. View

19.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View