KCNJ5 Somatic Mutation Is a Predictor of Hypertension Remission After Adrenalectomy for Unilateral Primary Aldosteronism
Carregando...
Citações na Scopus
47
Tipo de produção
article
Data de publicação
2019
Editora
ENDOCRINE SOC
Indexadores
Título da Revista
ISSN da Revista
Título do Volume
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, v.104, n.10, p.4695-4702, 2019
Resumo
Context: Primary aldosteronism (PA) is the most common cause of endocrine hypertension (HT). HT remission (defined as blood pressure <140/90 mm Hg without antihypertensive drugs) has been reported in approximately 50% of patients with unilateral PA after adrenalectomy. HT duration and severity are predictors of blood pressure response, but the prognostic role of somatic KCNJ5 mutations is unclear. Objective: To determine clinical and molecular features associated with HT remission after adrenalectomy in patients with unilateral PA. Methods: We retrospectively evaluated 100 patients with PA (60 women; median age at diagnosis 48 years with a median follow-up of 26 months). Anatomopathological analysis revealed 90 aldosterone-producing adenomas, 1 carcinoma, and 9 unilateral adrenal hyperplasias. All patients had biochemical cure after unilateral adrenalectomy. KCNJ5 gene was sequenced in 76 cases. Results: KCNJ5 mutations were identified in 33 of 76 (43.4%) tumors: p.Gly151Arg (n = 17), p.Leu168Arg (n = 15), and p.GIu145GIn (n = 1). HT remission was reported in 37 of 100 (37%) patients. Among patients with HT remission, 73% were women (P = 0.04), 48.6% used more than three antihypertensive medications (P= 0.0001), and 64.9% had HT duration <10 years (P= 0.0015) compared with those without HT remission. Somatic KCNJ5 mutations were associated with female sex (P = 0.004), larger nodules (P = 0.001), and HT remission (P = 0.0001). In multivariate analysis, only a somatic KCNJ5 mutation was an independent predictor of HT remission after adrenalectomy (P = 0.004). Conclusion: The presence of a KCNJ5 somatic mutation is an independent predictor of HT remission after unilateral adrenalectomy in patients with unilateral PA.
Palavras-chave
Referências
- Adolf C, 2018, J CLIN ENDOCR METAB, V103, P4543, DOI 10.1210/jc.2018-00617
- Arlt W, 2017, JCI INSIGHT, V2, DOI 10.1172/jci.insight.93136
- Arnesen T, 2013, LANGENBECK ARCH SURG, V398, P869, DOI 10.1007/s00423-013-1093-2
- Azizan EAB, 2013, NAT GENET, V45, P1055, DOI 10.1038/ng.2716
- Beuschlein F, 2013, NAT GENET, V45, P440, DOI 10.1038/ng.2550
- Celen O, 1996, ARCH SURG-CHICAGO, V131, P646
- Charmandari E, 2012, J CLIN ENDOCR METAB, V97, pE1532, DOI 10.1210/jc.2012-1334
- Choi M, 2011, SCIENCE, V331, P768, DOI 10.1126/science.1198785
- Fernandes-Rosa FL, 2014, HYPERTENSION, V64, P354, DOI 10.1161/HYPERTENSIONAHA.114.03419
- Funder JW, 2016, J CLIN ENDOCR METAB, V101, P1889, DOI 10.1210/jc.2015-4061
- Gerards J, 2019, J CLIN ENDOCR METAB, V104, P3192, DOI 10.1210/jc.2019-00299
- Heaton JH, 2012, AM J PATHOL, V181, P1017, DOI 10.1016/j.ajpath.2012.05.026
- Ip JCY, 2015, ANZ J SURG, V85, P279, DOI 10.1111/ans.12470
- Kitamoto T, 2018, J HYPERTENS, V36, P619, DOI 10.1097/HJH.0000000000001578
- Lenzini L, 2015, J CLIN ENDOCR METAB, V100, pE1089, DOI 10.1210/jc.2015-2149
- Lim V, 2014, J CLIN ENDOCR METAB, V99, P2712, DOI 10.1210/jc.2013-4146
- Malachias MVB, 2016, ARQ BRAS CARDIOL, V107, P1, DOI [10.5935/abc.20160162, 10.5935/abc.20160140]
- Meyer A, 2005, WORLD J SURG, V29, P155, DOI 10.1007/s00268-004-7496-z
- Milliez P, 2005, J AM COLL CARDIOL, V45, P1243, DOI 10.1016/j.jacc.2005.01.015
- Monticone S, 2018, LANCET DIABETES ENDO, V6, P41, DOI 10.1016/S2213-8587(17)30319-4
- Nanba K, 2019, HYPERTENSION, V73, P885, DOI 10.1161/HYPERTENSIONAHA.118.12070
- Nanba K, 2018, J CLIN ENDOCR METAB, V103, P3869, DOI 10.1210/jc.2018-01004
- Nanba K, 2012, J CLIN ENDOCR METAB, V97, P1688, DOI 10.1210/jc.2011-2504
- Okamura T, 2017, ENDOCR J, V64, P39, DOI 10.1507/endocrj.EJ16-0243
- Rossi GP, 2008, HYPERTENSION, V51, P1366, DOI 10.1161/HYPERTENSIONAHA.108.111369
- Rossi GP, 2006, J AM COLL CARDIOL, V48, P2293, DOI 10.1016/j.jacc.2006.07.059
- Rossi GP, 2013, HYPERTENSION, V62, P62, DOI 10.1161/HYPERTENSIONAHA.113.01316
- Savard S, 2013, HYPERTENSION, V62, P331, DOI 10.1161/HYPERTENSIONAHA.113.01060
- Sawka AM, 2001, ANN INTERN MED, V135, P258, DOI 10.7326/0003-4819-135-4-200108210-00010
- Scholl UI, 2013, NAT GENET, V45, P1050, DOI 10.1038/ng.2695
- STREETEN DHP, 1990, AM J HYPERTENS, V3, P360, DOI 10.1093/ajh/3.5.360
- Sukor N, 2010, J CLIN ENDOCR METAB, V95, P1360, DOI 10.1210/jc.2009-1763
- Tang L, 2018, INT J ENDOCRINOL, DOI 10.1155/2018/4920841
- Teo AED, 2015, NEW ENGL J MED, V373, P1429, DOI 10.1056/NEJMoa1504869
- Vilela LAP, 2017, ARCH ENDOCRIN METAB, V61, P305, DOI 10.1590/2359-3997000000274
- Williams B, 2018, EUR HEART J, V39, P3021, DOI 10.1093/eurheartj/ehy339
- Williams TA, 2017, LANCET DIABETES ENDO, V5, P689, DOI 10.1016/S2213-8587(17)30135-3
- Wu VC, 2017, SCI REP-UK, V7, DOI 10.1038/srep39121
Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - HC/InRad
Carregar mais Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - HC/InRad