Prevalence and impact of diabetes and prediabetes on presentation and complications of primary hyperaldosteronism at diagnosis

Table 1 Demographic variables, glycaemic and hypertensive parameters (mean ± SD)

	No diabetes (n = 30)	Prediabetes (n = 19)	T2DM (n = 29)	P value
Age (yr)	52.53 ± 13.71	55.89 ± 15.1	56 ± 10.13	NS
HbA1c (%)	5.277 ± 0.25	5.926 ± 0.24	7.463 ± 0.59	< 0.0001
FPG (mg/dL)	87.9 ± 6.46	105.4 ± 9.02	130.6 ± 21.12	< 0.0001
PPPG (mg/dL)	122.7 ± 9.75	154.9 ± 14	196.7 ± 38.03	< 0.0001
HTN duration (yr)	11.27 ± 7.18	14.05 ± 8.35	14.83 ± 7.44	NS
SBP (mmHg)	164.9 ± 10.93	165.6 ± 15.3	165 ± 15.01	NS
DBP (mmHg)	95.37 ± 14.88	94.95 ± 7.41	98 ± 17.36	NS
BMI	23.6 ± 1.3	24.4 ± 1.4	25.2 ± 3.6	0.0479

NS: Non-significant, P ≥ 0.05; P < 0.05: Statistically significant; T2DM: Type 2 diabetes mellitus; HbA1c: Glycated haemoglobin; FPG: Fasting plasma glucose; PPPG: Post prandial plasma glucose; HTN: Hypertension; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; BMI: Body mass index.

Table 2 Comparison of biochemical parameters at presentation (mean ± SD)

	Non-diabetes (n = 30)	Prediabetes (n = 19)	T2DM (n = 29)	P value
Serum potassium (mEq/L)	3.1 ± 0.6	3.0 ± 0.7	3.1 ± 0.5	NS
Serum Sodium (mEq/L)	139.1 ± 2.6	139.1 ± 2.1	139.9 ± 2.2	NS
PAC (ng/dL)	28.2 ± 21.1	31.95 ± 26.2	39.8 ± 55.8	NS
PRA (ng/ml/h)	0.4 ± 0.2	0.32 ± 0.2	0.3 ± 0.2	NS
ARR (ng/dL per ng/mL/h)	148.1 ± 253	270.7 ± 393.9	266.2 ± 506.8	NS
Aldo:K	10.7 ± 12.2	12.5 ± 12.9	15.3 ± 29.7	NS
PAC post SST (ng/dL)	15.6 ± 11.8	16.5 ± 13.6	15.8 ± 12.1	NS
Venous Bicarbonate (mEq/L)	24.3 ± 7.1	26 ± 5.0	23.6 ± 4.5	NS
Creatinine (mg/dL)	1.2 ± 0.5	1.1 ± 0.2	1.2 ± 0.2	NS
eGFR (mL/min/1.73 m2)	70.6 ± 24.2	76.7 ± 19.8	71.2± 16.2	NS

NS: Non-significant, P ≥ 0.05; P < 0.05: Statistically significant; T2DM: Type 2 diabetes mellitus; PAC: Plasma aldosterone concentration; PRA: Plasma renin activity; ARR: Aldosterone to renin ratio, Aldo:K: Aldosterone to potassium ratio; PAC post SST: Plasma aldosterone concentration post saline suppression test; eGFR: Estimated glomerular filtration rate.

Table 3 Comparison of the pattern of clinical presentation, n (%)

Presentation	Non-diabetes (n = 30)	Prediabetes (n = 19)	T2DM (n = 29)	P value
Resistant hypertension	7 (23.3)	1 (5.35)	3 (10.3)	NS
Spontaneous hypokalemia with hypertension	15 (50)	11 (57.9)	15 (51.7)	NS
Adrenal incidentaloma with hypertension	2 (6.7)	2 (10.5)	2 (6.9)	NS
Resistant hypertension with diuretic induced hypokalemia	6 (20)	5 (26.3)	9 (31)	NS
Mean number of antihypertensives (mean ± SD)	3.0 ± 0.6	2.9 ± 0.6	3.1 ± 0.7	NS
No. of antihypertensives
1	1 (3.3)	1 (5.3)	1 (3.4)	NS
2	3 (1.0)	1 (5.3)	2 (6.9)
3	22 (73.3)	16 (84.2)	19 (65.5)
4	4 (13.3)	1 (5.3)	6 (20.7)
5	0 (0)	0 (0)	1 (3.4)

NS: Non-significant, P ≥ 0.05; P < 0.05: Statistically significant; T2DM: Type 2 diabetes mellitus.

Table 4 Type and number Pattern of complications in the study population, n (%)

Comorbidities	Non-diabetes (n = 30)	Prediabetes (n = 19)	T2DM (n = 29)	P value
Mean number of complications (mean ± SD)	1.4 ± 0.97	1.5 ± 0.8	1.7 ± 0.8	NS
LVH	23 (76.7)	17 (89.5)	26 (89.7)	NS
CKD 3	17 (56.7)	12 (63.2)	17 (58.7)	NS
CAD	3 (10)	4 (21)	8 (27.6)	NS
CVA	1 (3.3)	3 (15.8)	1 (3.4)	NS
No. of complications
0	3 (10)	3 (15.8)	3 (10.3)	NS
1	2 (6.7)	2 (10.5)	4 (13.8)
2	7 (23.3)	8 (42.1)	12 (41.4)
3	18 (60)	6 (31.6)	9 (31)
4	0 (0)	0 (0)	1 (3.4)

NS: Non-significant, P ≥ 0.05; P < 0.05: Statistically significant; T2DM: Type 2 diabetes mellitus; LVH: Left ventricular hypertrophy; CKD: Chronic kidney disease; CAD: Coronary artery disease; CVA: Cerebrovascular accident; HTN: Hypertension; OSA: Obstructive sleep apnea.