关于原发性醛固酮增多症(PA)和原发性高血压(EH)患者的代谢相关疾病仍存在争议。采用系统评价和荟萃分析探讨代谢综合征(MS)患病率及PA和EH相关指标。PubMed,Embase,搜索了从开始到2023年12月的WebofScience和Cochrane中央对照试验登记册,以寻找合格的研究。Meta分析采用ReviewManager5.3和STATA15.1软件进行。共纳入12项研究,揭示PA和EH在MS患病率中没有显着差异(1.27[0.92,1.76],p=0.14)具有较高的异质性(I2=68%,p=0.0002),虽然它变得显著不同(1.45[1.17,1.81],p=0.0008)和较低的异质性(I2=26%,通过亚组分析,超重或肥胖的患者中p=0.19)。收缩压较高(2.99[0.67,5.31],p=0.01;I2=43%,p=0.06)和舒张压(2.10[0.82,3.38],p=0.001;I2=36%,p=0.11)具有较低的异质性,PA组甘油三酯较低,异质性较高(-0.23[-0.37,-0.09],p=0.001;I2=76%,观察到p<0.0001)。其他指标无显著性差异。这项研究表明,超重或肥胖的PA患者中MS的患病率更高。然而,在这些体重正常的患者中,情况不同。PA与糖脂代谢的关系有待进一步研究。
It remained debates on metabolic-related disorders in patients with primary aldosteronism (PA) and essential hypertension (EH). A systematic
review and meta-analysis was conducted to explore the prevalence of metabolic syndrome (MS) and the related indicators in PA and EH. PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials from their commencement to December 2023 were searched for eligible studies. The meta-analysis was performed by
Review Manager 5.3 and STATA 15.1 software. A total of 12 studies were included, revealing that there was no significant difference between PA and EH in the prevalence of MS (1.27[0.92, 1.76], p = 0.14) with higher heterogeneity (I2 = 68%, p = 0.0002), while it became significant different (1.45[1.17, 1.81], p = 0.0008) and lower heterogeneity (I2 = 26%, p = 0.19) in patients who were overweight or obese by subgroup analysis. Higher systolic blood pressure (2.99[0.67, 5.31], p = 0.01; I2 = 43%, p = 0.06) and diastolic blood pressure (2.10[0.82, 3.38], p = 0.001; I2 = 36%, p = 0.11) with lower heterogeneity, and lower triglyceride in PA group with higher heterogeneity (-0.23[-0.37, -0.09], p = 0.001; I2 = 76%, p < 0.0001) were observed. No significant difference was found in other indicators. This study showed a higher prevalence of MS in patients who were overweight or obese with PA. However, it was not the same in these patients who were in normal weight. More researches were needed to explore the relationship between PA and metabolism of glucose and lipid.