Influence of smoking on cardiometabolic profile and surgical outcomes in patients with primary aldosteronism. A cohort study.

IF 5.3 1区医学 Q1 ENDOCRINOLOGY & METABOLISM European Journal of Endocrinology Pub Date : 2024-11-18 DOI:10.1093/ejendo/lvae143

Marta Araujo-Castro, Miguel Paja Fano, Marga González-Boillos, Eider Pascual-Corrales, Paola Parra Ramírez, Patricia Martín Rojas-Marcos, Ana García-Cano, Jorge Gabriel Ruiz-Sanchez, Almudena Vicente, Emilia Gómez-Hoyos, Ana Casterás, Albert Puig-Perez, Iñigo García Sanz, Mònica Recasens, Rebeca Barahona San Millan, María José Picón César, Patricia Díaz Guardiola, Carolina Perdomo, Laura Manjón-Miguélez, Ángel Rebollo Román, Cristina Robles Lázaro, José María Recio, Manuel Morales-Ruiz, María Calatayud, Noemi Jiménez López, Diego Meneses, Miguel Sampedro Nuñez, Elena Mena Ribas, Alicia Sanmartín Sánchez, Cesar Gonzalvo Diaz, Cristina Lamas, María Del Castillo Tous, Joaquín Serrano, Theodora Michalopoulou, Susana Tenes Rodrigo, Ricardo Roa Chamorro, Fernando Jaén Aguila, Eva María Moya Mateo, Sonsoles Gutiérrez-Medina, Felicia Alexandra Hanzu

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Abstract

Aim: To evaluate the influence of smoking on cardiometabolic profile and surgical outcomes in patients with primary aldosteronism (PA).

Methods: Multicenter retrospective study of patients with PA in 36 Spanish tertiary hospitals with available information on smoking habits (smokers and non-smokers [never smokers and ex-smokers]).

Results: A total of 881 patients were included, of whom 180 (20.4%) were classified as smokers and 701 as non-smokers. At diagnosis, smokers and non-smokers did not differ in blood pressure or serum potassium levels between. However, smokers had a higher prevalence of left ventricular hypertrophy (LVH) than non-smokers (OR 2.0, 95% CI 1.23 to 3.25), and smokers were more likely to have severe LVH than non-smokers (12.5% vs. 6.6%, P=0.164). A larger mean tumor size of the adrenal nodule/s was observed in the smoking group (18.6±9.66 vs. 15.8±8.66 mm, P=0.002). In addition, the odds of mild autonomous cortisol secretion (MACS) was greater in smokers than in non-smokers (OR 2.1, 95% CI 1.14 to 4.06), but these differences disappeared when adjusted for the size of the adrenal nodule/s (adjusted OR 1.6, 95% CI 0.76 to 3.37). The rate of biochemical and hypertension cure was similar in both groups; however, hypertension cure tended to be more frequent in the non-smoker group (41.2% vs 29.9%, P=0.076).

Conclusions: Patients with PA who smoke have a higher prevalence of LVH and MACS and larger adrenal nodule/s than non-smokers. Smoking has no significant effect on the probability of hypertension response after adrenalectomy in patients with PA.

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吸烟对原发性醛固酮增多症患者心脏代谢状况和手术效果的影响。一项队列研究。

目的：评估吸烟对原发性醛固酮增多症（PA）患者心脏代谢情况和手术效果的影响：方法：对西班牙 36 家三级医院的 PA 患者进行多中心回顾性研究，并提供有关吸烟习惯的信息（吸烟者和非吸烟者[从不吸烟者和戒烟者]）：结果：共纳入 881 名患者，其中 180 人（20.4%）被归类为吸烟者，701 人被归类为非吸烟者。确诊时，吸烟者和非吸烟者的血压和血清钾水平没有差异。然而，吸烟者的左心室肥厚（LVH）发病率高于非吸烟者（OR 2.0，95% CI 1.23 至 3.25），而且吸烟者比非吸烟者更有可能患有严重的左心室肥厚（12.5% 对 6.6%，P=0.164）。吸烟组的肾上腺结节/肿瘤的平均大小更大（18.6±9.66 mm vs. 15.8±8.66 mm，P=0.002）。此外，吸烟者出现轻度自主皮质醇分泌（MACS）的几率大于非吸烟者（OR 2.1，95% CI 1.14 至 4.06），但根据肾上腺结节/s 的大小进行调整后，这些差异消失了（调整后 OR 1.6，95% CI 0.76 至 3.37）。两组患者的生化治愈率和高血压治愈率相似；但非吸烟组的高血压治愈率更高（41.2% vs 29.9%，P=0.076）：结论：与不吸烟者相比，吸烟的 PA 患者有更高的 LVH 和 MACS 患病率，肾上腺结节也更大。吸烟对 PA 患者肾上腺切除术后出现高血压反应的概率没有明显影响。

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来源期刊

European Journal of Endocrinology 医学-内分泌学与代谢

CiteScore

9.80

自引率

3.40%

发文量

354

审稿时长

1 months

期刊介绍： European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.