This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bentley-Lewis, R. Articles by Garg, R. Search for Related Content PubMed PubMed Citation Articles by Bentley-Lewis, R. Articles by Garg, R. Related Collections Adrenal and Hypertension Cardiovascular Endocrinology Obesity

Body Mass Index Predicts Aldosterone Production in Normotensive Adults on a High-Salt Diet

Divisions of Endocrinology, Diabetes, and Hypertension (R.B.-L., G.K.A., E.W.S., G.H.W., R.G.) and Cardiology (T.P.), Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115; and Division of Cardiology and Cardiovascular Genetics (P.N.H.), University of Utah, Salt Lake City, Utah 84112

Address all correspondence and requests for reprints to: Rajesh Garg, M.D., Brigham and Women’s Hospital, Division of Endocrinology, Diabetes, and Hypertension, 221 Longwood Avenue, Boston, Massachusetts 02115. E-mail: rgarg{at}partners.org.

Context: The mechanisms underlying obesity-mediated cardiovascular disease are not fully understood. Aldosterone and insulin resistance both are associated with obesity and cardiovascular disease.

Objectives: The objectives of this study were to test the hypotheses that aldosterone production is elevated and associated with insulin resistance in overweight adults on a high-sodium diet.

Participants/Interventions: Healthy normotensive adults were categorized as lean body mass index (BMI) less than 25 kg/m² (n = 63) or overweight BMI 25 kg/m² or greater (n = 57). After 7 d of a high-sodium diet, participants fasted overnight and remained supine throughout hemodynamic and laboratory assessments and angiotensin II (AngII) stimulation.

Results: The overweight group, compared with the lean group, had higher 24-h urinary aldosterone (9.0 ± 0.8 vs. 6.6 ± 0.5 µg per 24 h; P = 0.003) and higher AngII-stimulated serum aldosterone (11.4 ± 1.0 vs. 9.0 ± 0.6 ng/dl; P = 0.04). There were no differences in 24-h urinary cortisol or sodium or supine measurements of plasma renin activity, serum aldosterone, or serum potassium. The homeostasis model assessment of insulin resistance was predicted by urinary aldosterone excretion (r = 0.32, P = 0.03) and serum aldosterone response to AngII stimulation (r = 0.28, P = 0.02) independent of age and BMI.

Conclusion: Urinary aldosterone excretion and AngII-stimulated aldosterone are increased in overweight, compared with lean, normotensive adults. The correlation of these measures of aldosterone production with insulin resistance suggests a potential role for aldosterone in the pathophysiology of obesity-mediated insulin resistance.

This article has been cited by other articles:

				G. P. Rossi, A. Belfiore, G. Bernini, B. Fabris, G. Caridi, C. Ferri, G. Giacchetti, C. Letizia, M. Maccario, M. Mannelli, et al. Body Mass Index Predicts Plasma Aldosterone Concentrations in Overweight-Obese Primary Hypertensive Patients J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2566 - 2571. [Abstract] [Full Text] [PDF]

				A. W. Krug and M. Ehrhart-Bornstein Aldosterone and Metabolic Syndrome: Is Increased Aldosterone in Metabolic Syndrome Patients an Additional Risk Factor? Hypertension, May 1, 2008; 51(5): 1252 - 1258. [Full Text] [PDF]

				C. Guo, V. Ricchiuti, B. Q. Lian, T. M. Yao, P. Coutinho, J. R. Romero, J. Li, G. H. Williams, and G. K. Adler Mineralocorticoid Receptor Blockade Reverses Obesity-Related Changes in Expression of Adiponectin, Peroxisome Proliferator-Activated Receptor-{gamma}, and Proinflammatory Adipokines Circulation, April 29, 2008; 117(17): 2253 - 2261. [Abstract] [Full Text] [PDF]