A.M.A. Berends, E. Buitenwerf, E.G. Gruppen, W. J. Sluiter, S.J.L. Bakker, M.A. Connelly, M.N. Kerstens, R.P.F. Dullaart. Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Laboratory Corporation of America^® Holdings (LabCorp), Raleigh, NC, USA.

Background: Primary aldosteronism (PA) may confer increased cardiovascular risk beyond effects on systemic blood pressure, but contributing mechanisms remain incompletely understood. We compared plasma (apo)lipoproteins and lipoprotein particle characteristics, GlycA, a pro-inflammatory glycoprotein biomarker of enhanced chronic inflammation, and plasma total branched chain amino acids (BCAA), measured using nuclear magnetic resonance (NMR) spectroscopy, between patients with PA, control subjects without hypertension, subjects with untreated hypertension and subjects with treated hypertension.

Methods: 20 PA patients were individually matched with 2819 control subjects without hypertension, 501 subjects with untreated hypertension and 878 subjects with treated hypertension participating in the PREVEND (Prevention of Renal and Vascular End-Stage Disease) cohort study with respect to age, sex, body mass index, smoking and statin use. The Vantera® Clinical Analyzer was used to determine NMR-based laboratory parameters.

Results: Total cholesterol, LDL cholesterol, HDL cholesterol, apolipoprotein (apo) B, apoA-I, LDL particle and HDL particle concentrations were all decreased in PA subjects vs. control subjects and subjects with untreated hypertension (P<0.016). Triglycerides and triglyceride-rich lipoprotein (TRL) concentrations were lower in PA subjects vs. subjects with (untreated) hypertension. GlycA was increased in PA vs. the three comparator groups (P<0.016). Total BCAA concentrations were unaltered in PA.

Conclusions: PA is associated with lower concentrations of  LDL and HDL particles and to some extent also with lower TG and TRL particle concentrations. PA is also characterized by increased GlycA levels, indicating enhanced low grade chronic inflammation. Low HDL particle concentrations and increased GlycA could contribute to accelerated cardiovascular disease development in PA.