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A7550 Urinary Potassium Loss Induced by Hyperaldosterone secretion Associated with Diabetes Mellitus Prevalence in Patients with Hypertension

Objectives: Primary aldosteronism (PA) is characterized by aldosterone overproduction resulting in hypokalemia and increased urinary potassium excretion. Diabetes was highly associated with PA involved in hypokalemia which was related to chronic urinary potassium excretion. The aim of this study was to invistigate whether hyperaldosterone and urinary potassium excretion could increase the risk of diabetes in patients with PA. Methods: 790 hypertensive inpatients were enrolled. DM participants included patients with known or newly-diagnosed diabetes. All of them entered a protocol for screening PA. The positive screening was based on aldosterone /renin activity (ARR) ≥ 20 ng/dL per ng/mL/h. PA diagnosis was based on ARR ≥ 20 ng/dL per ng/mL/h plus PAC ≥ 10 ng/dL after saline infusion test. The association of hyperaldosterone or urinary potassium excretion with DM prevalence was evaluated during the every step of screening for PA. Results: In positive initial screening group, 24 h-urine potassium tertile (OR 2.221, 95%CI 1.251–3.942, p < 0.01) levels or PAC tertile (OR 1.728, 95%CI 1.091–2.737, p < 0.05) associated with DM prevelance. Compared with 86 age- and sex-matched patients without PA, patients with PA had significantly higher DM prevalence (29.1% vs 9.3%, P < 0.01). And the level of 24h-urine K + (52.5 + 17.0 vs 46.7 + 21.3 vs 35.7 + 17.7mmol/L, P < 0.05) and PAC (22.4 + 9.9 vs 22.9 + 17.2 vs 12.8 + 5.53 ng/dL, P < 0.05) were highest in PA&DM group, moderate in PA group and lowest in non-(PA&DM) group match for -age and -sex in a 1:1:1 fashion. Conclusion: Urinary potassium loss induced by hyperaldosteronism associated with DM prevalence in hypertensive patients, which suggested that the prevention of DM may not only focus on potassium supplementation but also interfering in urinary potassium loss in PA.