Endocrine Abstracts

Background: Significant prevalence of hypertension in the world’s population and its consequences tend to an intensive search for pathogenesis and etiology of this disease. Epidemic of hypertension is accompanied by an epidemic of adrenal incidentaloma and grows in direct proportion to patients age. Polymorphism of aldosterone synthase (CYP11B2) in -344th region of promoter seems to have much in common with hypertension and adrenal incidentaloma.

Aim: The aim of this study was to assess what role may play CYP11B2 polymorphism in the phenotype of hypertension with associated adrenal incidentaloma. In this study, the analysis of alleles and genotypes focused on incidence of adrenal tumour and impact on the number of antihypertensive medications required to proper control.

Subjects and methods: Study was performed on 106 hypertensive patients with diagnosed adrenal incidentaloma (HAI), on 44 hypertensive patients without adrenal incidentaloma (HWAI) and on 63 healthy individuals forming control group. Groups matched to each other in terms of age, gender. Related patients and those who suffered from disease that may falsely affect the results were excluded. Severity of hypertension was determined by number of antihypertensive medications used to control. The significance of differences between the groups was evaluated through chi-square and Student’s t-test.

Results: TT genotype and T allel occurred significantly less frequently in HAI in comparison with Control Group (respectively: P=0.049; P=0.04). Patients with TT genotype needed more medication to control hypertension in comparison with CC genotype (3,080 vs 2,361, P=0.0439). Lack of significant differences between HWAI to the rest groups.

Conclusions:

• The presence of the C allele in the region of -344 aldosterone synthase promoter predisposes to adrenal tumour, the TT genotype reduced that risk.

• Hypertension in patients with CC genotype is less severe, regardless of its phenotype.