Non-Alcoholic Fatty Liver Disease and Hypokalemia in Primary Aldosteronism Among Chinese Population

Front Endocrinol (Lausanne). 2021 Apr 22:12:565714. doi: 10.3389/fendo.2021.565714. eCollection 2021.

Abstract

Background: In recent years, evidence that aldosteronism is a risk factor for metabolic disorders has increased. This study was designed to investigate the role of nonalcoholic fatty liver disease (NAFLD) and hypokalemia in primary aldosteronism (PA).

Methods: A total of 222 patients diagnosed with PA and 222 non-PA patients were included in our study. Demographic data, medical histories, clinical evaluations, complete blood counts, serum biochemical analyses, aldosterone and potassium levels were obtained. Data are presented as the means ± standard deviation (SD). To compare the parameters between cases and controls, Student's t-tests or Mann-Whitney U tests were used for continuous variables, and χ2 tests were used for categorical variables. Pearson correlation analysis was used to define relationships between pairs of parameters. A two-sided P < 0.05 was considered statistically significant. Multivariate logistic regression was performed to assess the independent effects of potassium and other metabolic variables on NAFLD in PA patients.

Results: The diagnosis of NAFLD was more common in PA patients (n=222, 35.1%) than in non-PA subjects (29.7%). PA patients with and without NAFLD had similar metabolic imbalance characteristics. In PA patients with hypokalemia, relatively higher prevalences of NAFLD (44% vs. 27%, P < 0.05) and diabetes mellitus (19.8% vs. 9.9%, P < 0.05) were observed. Hypokalemic PA patients had a worse metabolic status than PA patients without hypokalemia, including higher body mass index (BMI) (25.4 ± 3.4 vs. 24.1 ± 3.9 kg/m2, P < 0.05), more severe dyslipidemia as well as insulin resistance, higher serum uric acid levels (354 ± 95 vs. 319 ± 87 μmol/L, P < 0.01) and aggravated inflammation.

Conclusion: The prevalence of NAFLD was higher in PA patients than in non-PA patients, although the patterns of obesity, dyslipidemia and insulin resistance were similar. Hypokalemic PA patients had a worse metabolic status than normokalemic PA patients. This study provides new insights that can inform further mechanistic studies about metabolic imbalance in patients with aldosteronism.

Keywords: hypokalemia; inflammation; insulin resistance; non-alcoholic fatty liver disease; primary aldosteronism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • China / epidemiology
  • Female
  • Humans
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / epidemiology*
  • Hypokalemia / epidemiology*
  • Hypokalemia / etiology
  • Inflammation / complications
  • Inflammation / epidemiology
  • Insulin Resistance / physiology
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / epidemiology*
  • Non-alcoholic Fatty Liver Disease / etiology
  • Prevalence
  • Risk Factors