アクティブボード・２０１６年９月
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研究発表を行った学会；
・The 9th International Aldosterone Forum in Japan
　　2016年 5月28日（東京）

タイトル；Appropriate treatments in primary aldosteronism improve glucose homeostasis and protect islet function..
発表者；後藤　理英子　氏
　　　（熊本大学　生命科学研究部　代謝内科学分野）
要旨；
Purpose：Primary aldosteronism (PA) often accompanies with impaired glucose tolerance (IGT) or diabetes, but this mechanism hasn’t been clearly elucidated. We conducted a case-series study to analyze the clinical characteristics of glucose homeostasis in PA patients. We also examined the study with the purpose of revealing the protective effect for islets by adrenalectomy or blockade of mineralocorticoid receptor (MR).
Methods：The glucose tolerance in 73 patients with PA was analyzed. Eighteen cases of them underwent 75g OGTT, 11 cases were examined by euglycemic glucose clamp study, 6 cases were evaluated by active GLP-1 levels before and at 6 months after treatments such as adrenalectomy or oral eplerenone administration.
Results：Impairment of glucose tolerance was observed in 79% of 73 patients with PA. Inslinogenic index (I.I.) was significantly improved after treatment (0.5 ± 0.2 vs 0.9 ± 0.3). IRI was significantly increased at 60 minutes on OGTT after oral eplerenone treatment (42.1 ± 27.3 vs 63.3 ± 33.1 μU/mL). There was no significant difference in the M/I value by the euglycemic glucose clamp examination (7.9 ± 3.9 vs 7.2 ± 4.1 mg/kg/min/mU/L×100). Fasting and postprandial active GLP-1 concentration were significantly increased after the oral eplerenone treatment (fasting: 1.8 ± 0.5 vs 2.5 ± 0.6, postprandial: 3.1 ± 1.2 vs 5.8 ± 2.2 pmoL/L).
Conclusions：Aldosterone excess state may deteriorate glucose metabolism due to impaired early phase insulin secretion. Appropriate treatments in PA may restore the insulin secretion and improve glucose homeostasis via active GLP-1 secretion.