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Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio

Journal of Human Hypertension volume 32, pages 524–530 (2018)Cite this article

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Abstract

Plasma aldosterone/renin ratio (ARR) is a useful method for primary aldosteronism (PA) screening. However some confounders, such as medications and dietary, affect plasma renin and aldosterone levels, resulting in false-negative or -positive plasma ARR. This study investigated the association between postmenopausal osteoporosis (PMO) and plasma ARR. Bone mineral density (BMD) was measured by dual-energy X-ray-absorptiometry (DXA) in 324 normotensive postmenopausal women. Based on clinical characteristics and BMD, 186 and 96 subjects were diagnosed as PMO and osteopenia respectively, and the remaining 42 subjects were grouped as normal BMD. Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), parathyroid hormone (PTH), bone alkaline phosphatase (BALP) and 25-Hydroxyvitamin D(25-(OH)D) were determined. Subjects with PMO showed significantly higher levels of PAC (121.0 ± 78.8 vs. 81.8 ± 71.5 pg/ml, p < 0.01 and 121.0 ± 78.8 vs. 91.7 ± 56.2 pg/ml, p < 0.01) and ARR (32.0 ± 53.6 vs. 9.0 ± 9.3 pg/μU, p < 0.01 and 32.0 ± 53.6 vs. 16.3 ± 32.1 pg/μU, p < 0.01) compared to women with normal BMD and osteopenia, respectively. Using ARR ≥ 37.0 pg/μU as the cutoff for positive screening, more false-positive was found in the PMO group when compared to the normal BMD group (24 vs. 2%) and osteopenia group (24 vs. 7%), respectively. PAC was negatively associated with lumbar spine BMD T-score (r = −0.239, p < 0.001), femur neck BMD T-score (r = −0.234, p < 0.001) and total hip BMD T-score (r = −0.228, p < 0.001). PTH was positively associated with PAC (r = 0.119, p < 0.05) and ARR (r = 0.136, p < 0.05). PAC and ARR are elevated in women with PMO, which might increase the risk of false-positive for case detection of PA.

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Acknowledgements

The sources of funding include the National Natural Science Foundation of China (81370954, 81670785) to Qifu Li; and the Fundamental Science & Advanced Technology Research of Chongqing (Major Project, cstc2015jcyjBX0096) to Qifu Li. Chongqing Science and Technology Committee Innovation Project (Technology Development and Application of Precision Medicine, cstc2016shms-ztzx1003) to Qifu Li.

Membership of the Chongqing Primary Aldosteronism Study(CONPASS) Group

Qifu Li, MD, PhD; Ying Song, MD; Shumin Yang, MD, PhD; Wenwen He, MD; Mei Mei, MD, PhD; Jinbo Hu, PhD; Suxin Luo, MD, PhD; Kangla Liao, MD; Yao Zhang, MD, PhD; Yunfeng He, PhD; Yihong He; Ming Xiao, PhD; and Bin Peng, PhD.

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  1. These authors contributed equally: Xiaoyu Shu, Mei Mei.

Authors and Affiliations

  1. Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Xiaoyu Shu, Mei Mei, Linqiang Ma, Zhihong Wang, Shumin Yang, Jinbo Hu, Ying Song, Wenwen He, Ting Luo, Qingfeng Cheng, Yue Wang, Qianna Zhen & Qifu Li

  2. Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China

    Xiaoyu Shu

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Membership of the CONPASS group is provided in the Acknowledgements.

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Shu, X., Mei, M., Ma, L. et al. Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio. J Hum Hypertens 32, 524–530 (2018). https://doi.org/10.1038/s41371-018-0069-7

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