Alteration of Gut Microbiota Relates to Metabolic Disorders in Primary Aldosteronism Patients

PurposeThis study aimed to determine the relationships among gut microbiota, primary aldosteronism (PA), and related metabolic disorders.MethodsThe study enrolled 13 PA patients, 26 sex-matched primary hypertension patients, and 26 sex-matched healthy controls. Demographic and clinical characteristics such as age, body mass index (BMI), blood aldosterone–renin ratio, blood potassium, blood glucose, blood lipid parameters, and history of diabetes mellitus (DM) were compared between the three groups. The gut microbiota of each participant was examined by 16S rRNA gene sequencing. Spearman correlation analysis was performed to demonstrate the relationship between gut microbiota and clinical characteristics.ResultsBMI and the percentage of DM in PA patients were higher than those in healthy controls (p < 0.05), but not higher than those in primary hypertension patients (p > 0.05). The gut microbiota of healthy controls and primary hypertension patients had a higher alpha diversity level than that of PA patients. PA patients had fewer short-chain fatty acid (SCFA)-producing genera (Prevotella, Blautia, Coprococcus, Anaerostipes, and Ruminococcus) and more inflammation-associated genera (Megamonas, Sutterella, and Streptococcus) than healthy controls (p < 0.05). The gut microbiota of PA patients was more inclined to encode microbial pathways involved in sugar metabolism, such as starch and sucrose metabolism and fructose and mannose metabolism. Blood potassium was negatively correlated with the relative abundance of Romboutsia (R = −0.364, q = 0.023). Diastolic blood pressure (DBP) was positively correlated with Romboutsia (R = 0.386, q = 0.015). Systolic blood pressure (SBP) was negatively correlated with Blautia (R = −0.349, q = 0.030).ConclusionsThe alteration of gut microbiota in PA patients, especially bacteria and pathways involved in inflammation, SCFAs, and sugar metabolism, may be associated with chronic metabolic disorders.

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In Primary Aldosteronism the Circadian Blood Pressure Rhythm is Similar to That in Primary Hypertension

Clinical and Experimental Hypertension ◽

10.3109/10641969409067967 ◽

1994 ◽

Vol 16 (5) ◽

pp. 659-673 ◽

Cited By ~ 16

Author(s):

M. Penzo ◽

P. Palatini ◽

G. P. Rossi ◽

L. Zanin ◽

A. C. Pessina

Keyword(s):

Blood Pressure ◽

Primary Aldosteronism ◽

Primary Hypertension ◽

Circadian Blood Pressure

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The Gastrointestinal Tract: an Initial Organ of Metabolic Hypertension?

Cellular Physiology and Biochemistry ◽

10.1159/000443107 ◽

2016 ◽

Vol 38 (5) ◽

pp. 1681-1694 ◽

Cited By ~ 16

Author(s):

Zhiming Zhu ◽

Shiqiang Xiong ◽

Daoyan Liu

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Gastrointestinal Tract ◽

Gut Microbiota ◽

Metabolic Disorders ◽

Kidney Diseases ◽

Vascular Dysfunction ◽

Taste Perception ◽

Global Public Health ◽

Gut Hormone

Hypertension is an important global public-health challenge because of its high prevalence and concomitant risks for cardiovascular and kidney diseases. More than 60% of the risk factors for hypertension are associated with metabolic disorders. Furthermore, many metabolic risk factors can directly cause the vascular dysfunction and the elevated blood pressure. Metabolic disorders not only increase the risk for hypertension but also participate in the development of hypertension. Thus, some types of hypertension induced by metabolic disturbances can be defined as metabolic hypertension. However, the pathogenesis of metabolic hypertension remains largely unknown. The gastrointestinal tract is a unique gate through which external food, metabolites, and microbes enter the human body. Thus, metabolism-related risk factors may affect blood pressure through the gastrointestinal tract and alter processes such as taste perception, mucosal absorption, gut hormone homeostasis, GI nerve activity, and gut microbiota. Meanwhile, gastrointestinal intervention through dietary approaches, gut microbiota modification, and metabolic surgery could profoundly improve or remit the vascular dysfunction and metabolic hypertension. It suggests that the GI tract could be an initial organ of metabolic hypertension. However, more clinical and basic studies are necessary to further validate this novel concept.

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Clinical Characteristics of Aldosterone- and Cortisol-Coproducing Adrenal Adenoma in Primary Aldosteronism

International Journal of Endocrinology ◽

10.1155/2018/4920841 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Lu Tang ◽

Xintao Li ◽

Baojun Wang ◽

Xin Ma ◽

Hongzhao Li ◽

...

Keyword(s):

Primary Aldosteronism ◽

Cardiovascular Events ◽

Clinical Characteristics ◽

Metabolic Disorders ◽

Adrenal Adenoma ◽

Cardiovascular Complications ◽

Pcr Analysis ◽

Cortisol Secretion ◽

Quantitative Real Time Pcr ◽

Biological Features

Aldosterone- and cortisol-coproducing adrenal adenoma (A/CPA) cases have been observed in patients with primary aldosteronism (PA). This study investigated the incidence, clinical characteristics, and molecular biological features of patients with A/CPAs. We retrospectively identified 22 A/CPA patients from 555 PA patients who visited the Chinese People’s Liberation Army General Hospital between 2004 and 2015. Analysis of clinical parameters revealed that patients with A/CPAs had larger tumors than those with pure APAs (P<0.05). Moreover, they had higher proportions of cardiovascular complications, glucose intolerance/diabetes, and osteopenia/osteoporosis compared to the pure APA patients (P<0.001). In the molecular biological findings, quantitative real-time PCR analysis revealed similar CYP11B1 and CYP17A1 mRNA expressions in resected A/CPA specimens and in pure APA specimens. Western blot and immunochemical analyses showed CYP11B1, CYP11B2, and CYP17A1 expressions in both A/CPAs and pure APAs. Seventeen cases with KCNJ5 mutations were detected among the 22 A/CPA DNA samples, but no PRKACA or other causative mutations were observed. Each patient improved following adrenalectomy. In conclusion, A/CPAs were not rare among PA patients. These patients associated with high incidences of cardiovascular events and metabolic disorders. Screening for excess cortisol secretion is necessary for PA patients.

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Relationship between Accessory Renal Artery and Clinical Characteristics of Middle-Aged Patients with Primary Hypertension

International Journal of Hypertension ◽

10.1155/2020/7109502 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Kai Kang ◽

Yeshuo Ma ◽

Chongfu Jia ◽

Yunpeng Cheng ◽

Yingchao Yang ◽

...

Keyword(s):

Blood Pressure ◽

Renal Artery ◽

Clinical Characteristics ◽

Left Ventricular ◽

Primary Hypertension ◽

Middle Aged ◽

Blood Pressure Monitor ◽

Aged Patients ◽

Accessory Renal Artery ◽

Plasma Aldosterone Concentration

Objectives. The association between accessory renal artery (ARA) and hypertension remains not fully understood. We observed the association between ARA and clinical characteristics among middle-aged patients with primary hypertension. Methods. One hundred and sixty-two middle-aged (mean 39.82 ± 10.25 years, 58.0% male) patients with primary hypertension were enrolled, and patients underwent Computed Tomography Angiography (CTA) of renal arteries, ambulatory blood pressure monitor (ABPM), echocardiography, physical examination, and routine blood chemistry examinations. According to the CTA results, patients were divided into a non-ARA (n = 108) and ARA (n = 54) group. Direct renin concentration (DRC), plasma aldosterone concentration (PAC), ABPM, echocardiography, creatinine, and glomerular filtration rate were compared between the two groups. Results. DRC (mU/L) (11.21 (5.34, 20.87) vs. 18.24 (10.32, 33.59), P=0.002) was significantly higher in the ARA group than in the non-ARA group. However, PAC (ng/dL) (98.30 (67.30, 134.00) vs. 116.50 (78.80, 137.25), P=0.103) was similar between these two groups. ABPM (mmHg) results showed that daytime (146.75 ± 17.04/95.86 ± 11.39 vs. 155.50 ± 14.76/100.48 ± 10.69, P<0.05), night time (133.44 ± 17.50/85.28 ± 12.80 vs. 139.81 ± 14.64/89.83 ± 11.21, P<0.05), and 24 h blood pressure (143.95 ± 15.99/93.90 ± 11.78 vs. 152.07 ± 13.85/98.11 ± 10.36, P<0.05) were significantly higher in the ARA group than in the non-ARA group. Accordingly, echocardiographic-derived posterior left ventricular wall thickness value was higher in the ARA group than in the non-ARA group. Conclusion. ARA is related to higher blood pressure and higher direct renin concentration in middle-aged patients with primary hypertension, and these patients deserve stricter blood pressure control. Our results provide important evidence for that ARA is a cause of hypertension and target organs damages.

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Metagenomic Study Revealed the Potential Role of the Gut Microbiome in Gout

10.1101/2019.12.21.19014142 ◽

2019 ◽

Author(s):

Yongliang Chu ◽

Yufen Huang ◽

Qingchun Huang ◽

Xuefeng Xie ◽

Peng Wang ◽

...

Keyword(s):

Gut Microbiota ◽

Gut Microbiome ◽

Lipid A ◽

Metabolic Diseases ◽

Healthy Controls ◽

Positive Performance ◽

Metagenomic Study ◽

Anti Inflammatory ◽

Mannose Metabolism

ABSTRACTEmerging evidence has indicated an association between the gut microbiome and arthritis diseases including gout. This metagenomic study aims to investigate the possible role of gut microbiota in the development of gout. The results exhibit gout patients have higher abundance of Prevotella, Fusobacterium spp. and Bacteroides spp., whereas healthy controls have higher abundance of Enterobacteriaceae spp., butyrate-producing species, including Roseburia spp., Butyrivibrio spp. and Coprococcus spp. and anti-inflammatory Faecalibacterium prausnitzii. Functional analysis shows gut microbiome of gout patients have higher potential for fructose, mannose metabolism and lipid A biosynthesis, but lower potential for urate degradation and SCFAs production. Enterobacteriaceae spp. may contribute to urate degradation and provide immunostimulatory effect in healthy controls. A disease classifier based on gut microbiota shows positive performance in the discovery and validation cohorts (93.03% and 89.13% accuracy, respectively). The effect of uric-acid-lowering and anti-inflammatory drugs on the gut microbiome is mild. Integrative analyses of four additional diseases (obesity, type 2 diabetes, ankylosing spondylitis and rheumatoid arthritis) indicates gout seems to be more similar to autoimmune diseases than metabolic diseases. This work demonstrates an altered gut microbiota might influence the development of gout and provides new insights into the diagnosis and treatment of the disease.

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Gut Microbiome Alterations in Patients With Carotid Atherosclerosis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.739093 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jingfeng Chen ◽

Qian Qin ◽

Su Yan ◽

Yang Yang ◽

Hang Yan ◽

...

Keyword(s):

Blood Pressure ◽

Gut Microbiome ◽

Clinical Characteristics ◽

Carotid Atherosclerosis ◽

Density Lipoprotein ◽

Abundant Species ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Healthy Controls ◽

Gut Microbes

Carotid atherosclerosis (CAS) is a reflection of systemic atherosclerosis and the main pathological processes of cardiovascular disease (CVD), namely, carotid intima–media thickening, carotid plaque formation, and carotid stenosis. Accumulating evidence indicates that the gut microbiota plays an important role in CVD and gut–brain disorders, but the associations of the composition and metabolites of the gut microbiome with CAS have not been studied comprehensively. We performed a gut microbiome genome-wide association study in 31 patients with CAS and 51 healthy controls using whole-genome shotgun sequencing. We found that several risk factors (waist circumference, body mass index, diastolic blood pressure, systolic blood pressure, fasting blood glucose, glycated hemoglobin A1c, total cholesterol, triglyceride, and low-density lipoprotein cholesterol) and inflammatory markers (white blood cell count and absolute value of neutrophils) were significantly higher in the CAS group than in the control group. In addition, 21 species and 142 pathways were enriched in the CAS group, and 10 species and 1 pathway were enriched in the control group. Specifically, Bacteroides eggerthii, Escherichia coli, and Klebsiella pneumoniae were the most abundant species in the CAS group, whereas Parabacteroides unclassified, Prevotella copri, Bacteroides sp 3_1_19, and Haemophilus parainfluenzae were the most abundant species in the control group. Finally, we found that most gut microbes and microbial pathways that were enriched in the CAS group had significant positive correlations with clinical characteristics, whereas the microbes and pathways enriched in healthy controls had significant negative correlations with clinical characteristics excluding high-density lipoprotein cholesterol. In addition, the associations between gut microbes and some microbial pathways (short-chain fatty acid, lipopolysaccharide, and menaquinol biosynthesis) were identified. Our results indicate the existence of a cyclic pathway that elevates the circulating concentrations of trimethylamine-N-oxide in patients with CAS but reduces its concentrations in healthy controls.

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Heightened Stress Reactivity in Response to an Attachment Related Stressor in Patients With Medically Treated Primary Hypertension

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.718919 ◽

2021 ◽

Vol 12 ◽

Author(s):

Elisabeth M. Balint ◽

Marc N. Jarczok ◽

Dominik Langgartner ◽

Stefan O. Reber ◽

Simon Endes ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Arterial Stiffness ◽

Regression Models ◽

Stress Reactivity ◽

Mixed Effects ◽

Primary Hypertension ◽

Healthy Controls ◽

Hypertensive Patients ◽

Linear Mixed Effects

Background: A heightened stress reactivity to mental stress tasks has been shown in hypertensive patients and might contribute to a higher disease risk. We investigated this hyperreactivity with regard to an attachment related stressor that focuses on emotions instead of performance and we examined whether this effect can also be found in patients on antihypertensive drugs.Materials and Methods: Fifty patients with primary hypertension, treated with at least one antihypertensive drug, were compared with 25 healthy individuals. After 10 min of rest, they participated in an attachment-related interview (Adult Attachment Projective picture system, AAP) and were exposed to an attachment-related stressor (Separation Recall, SR), a short-time stressor which activates attachment-related emotions and thoughts by talking 5 min about a personal experience of loneliness. Blood samples to measure adrenocorticotrope hormone (ACTH), cortisol, norepinephrine, epinephrine, and dopamine were taken. Blood pressure, heart rate and arterial stiffness were measured at rest, after AAP, after SR and 10 min after recovery. Standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD) were calculated. Parameters were compared using Mann Whitney U-test and linear mixed-effects regression models controlling for age and body mass index (BMI) after logarithmic transformation if appropriate.Results: Healthy test persons were younger and had lower BMI than patients. Comparing the two groups there were no significant differences in blood pressure and heart rate at rest. Both stressors provoked a significant response in almost all parameters. Results of the post-estimation of contrasts from linear mixed-effects regression models showed a steeper rise in systolic BP and arterial stiffness as well as a more pronounced decline in SDNN in hypertensive patients than in healthy controls. Levels of cortisol rose earlier and higher in hypertensive patients than in healthy controls.Conclusion: Vascular, autonomic, and hypothalamic pituitary adrenal axis response is heightened in medicated subjects with hypertension in response to attachment-focused stressors compared to healthy subjects. We conclude that the remaining hyper-reactivity even with sufficient antihypertensive medication still poses a substantial risk for affected patients. New ways to diminish this risk should be developed.

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