Endocrine Abstracts

Background: Primary aldosteronism constitutes the most common form of hormonal hypertension. However, it is often mistreated and widely underdiagnosed. Despite the great progress in laboratory technics of adrenal diseases, in the field of primary aldosteronism there is still a need for novel biomarkers that would clarify the diagnosis in equivocal cases. Adropin is a newly discovered protein that may play a role in glucose metabolism and the development of cardiovascular diseases connected to endothelial dysfunction. Lower adropin concentrations has been discovered in patients with primary arterial hypertension in comparison to healthy volunteers. No difference has been yet observed between patients with or without target organ damage related to hypertension, which is most pronounced in primary aldosteronism and refractory hypertension.

Objective: The aim of our studywas to evaluate the differences in adropin levels in hypertensive patients depending on their hormonal status.

Methodology: Adropin, aldosterone and renin concentrations from 80 hypertensive patients were analyzed. 20 patients were diagnosed with primary aldosteronism, 60 patients had primary hypertension. From the whole group, 17 patients had refractory hypertension – only 5 of them had primary aldosteronism. 45% of patientswith primary aldosteronism and 51.6% with primary hypertension had glucose metabolism disorders, including type 2 diabetes and pre-diabetes. Adropin was measured by ELISA method.

Results: Median adropin concentrations in primary aldosteronism were not statistically different from primary hypertension group: 33.2 ng/l versus 45.1 ng/l (P = 0.3). What’s interesting, adropin concentrations were the lowest in patients with refractory hypertension (independently of aldosterone secretion status): median 32.1 ng/l comparing to median 58.6 ng/l (P = 0.0545) in the group of patients with no refractory hypertension. There was significant difference between the youngest patients (under 40 years of age) in comparison to the older population – 1042.8 ng/l versus 34.9 ng/l (P = 0.04), respectively. Patients with glucose metabolism disorders had lower, but not statistically different, adropin levels versus patients with normal glucose levels – 34.6 vs 240.1 ng/l (P = 0.07), respectively.

Conclusions: To our knowledge, this is the first study to assess adropin concentrations in primary aldosteronism. Because of the small sample, the role of adropin needs further evaluation in larger population.