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Sci Rep. 2015 Jun 12;5:11396. doi: 10.1038/srep11396.

Prevalence and clinical correlates of somatic mutation in aldosterone producing adenoma-Taiwanese population.

Author information

1
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan.
2
Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan.
3
Division of Urology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan.
4
Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan.
5
Medical Imagine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan.

Abstract

Primary aldosteronism (PA) is a common form of secondary hypertension and has significant cardiovascular consequences. Mutated channelopathy due to the activation of calcium channels has been recently described in aldosterone-producing adenoma (APA). The study involved 148 consecutive PA patients, (66 males; aged 56.3 ± 12.3years) who received adrenalectomy, and were collected from the Taiwan PA investigator (TAIPAI) group. A high rate of somatic mutation in APA was found (n=91, 61.5%); including mutations in KCNJ5 (n=88, 59.5%), ATP1A1 (n=2, 1.4%), and ATP2B3 (n=1, 0.7%); however, no mutations in CACNA1D were identified. Mutation-carriers were younger (<0.001), had lower Cyst C (p=0.042), pulse wave velocity (p=0.027), C-reactive protein (p=0.042) and a lower rate of proteinuria (p=0.031) than non-carriers. After multivariate adjustment, mutation carriers had lower serum CRP levels than non-carriers (p=0.031. Patients with mutation also had a greater chance of recovery from hypertension after operation (p=0.005). A high incidence of somatic mutations in APA was identified in the Taiwanese population. Mutation-carriers had lower CRP levels and a higher rate of cure of hypertension after adrenalectomy. This raises the possibility of using mutation screening as a tool in predicting long-term outcome after adrenalectomy.

PMID:
26066391
PMCID:
PMC4464349
DOI:
10.1038/srep11396
[Indexed for MEDLINE]
Free PMC Article

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