[HTML][HTML] Prevalence and clinical correlates of somatic mutation in aldosterone producing adenoma-Taiwanese population

VC Wu, KH Huang, KY Peng, YC Tsai, CH Wu… - Scientific reports, 2015 - nature.com
VC Wu, KH Huang, KY Peng, YC Tsai, CH Wu, SM Wang, SY Yang, LY Lin, CC Chang…
Scientific reports, 2015nature.com
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±12.3 years) 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 …
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.
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