{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:31:29Z","timestamp":1789475489113,"version":"build-2803163510"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The relationship of glycemic abnormalities between primary aldosteronism (PA) patients and essential hypertension (EH) patients is still debatable. This meta-analysis aimed to explore differences in the prevalence of glycemic abnormalities and levels of abnormal glucose metabolism in PA and EH patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A search was performed using <jats:italic>PubMed<\/jats:italic>, <jats:italic>Scopus, Cochrane<\/jats:italic> and <jats:italic>Web of Science<\/jats:italic> databases from their inception through January 2022. Inclusion criteria for this study were 1) observational studies which contained specific data of interest, 2) studies including data which compared adult PA and EH patients and 3) studies which used appropriate methods to diagnose PA. Risk ratio (RR) or standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-six studies involving 53,186 patients were included in the meta-analysis. Patients with PA demonstrated significantly higher overall incidence of glycemic abnormalities than patients with EH [RR 1.54; 95% CI (1.20,1.98)]. Risk of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in PA patients were higher than in EH patients [RR 1.27; 95%CI (1.08, 1.49) and RR 2.99; 95%CI (1.74, 5.16), respectively]. There was no statistically significant difference of risk between these groups for impaired fasting glucose (IFG) [RR 1.70; 95%CI (0.55, 5.26)]. Moderate heterogeneity was observed in overall glycemic abnormalities outcomes. A high level of heterogeneity was observed for IFG, while the level was low for DM and IGT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PA patients have a higher risk of glycemic abnormalities than in EH patients. Further study should be conducted to investigate underlying mechanisms of glycemic abnormalities in PA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>www.inplasy.com,<\/jats:uri> INPLASY, identifier 202220004.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.870047","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T14:08:49Z","timestamp":1648735729000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Differences in Glycemic Abnormalities Between Primary Aldosteronism and Essential Hypertension: A Systematic Review and Meta-Analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Worapaka","family":"Manosroi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pichitchai","family":"Atthakomol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pittaporn","family":"Wattanawitawas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supawan","family":"Buranapin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"101365","DOI":"10.1016\/j.beem.2019.101365","article-title":"Prevalence, Diagnosis and Outcomes of Treatment for Primary Aldosteronism","volume":"34","author":"Yang","year":"2020","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.052","article-title":"Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practice","volume":"69","author":"Monticone","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.14359","article-title":"Screening Rates for Primary Aldosteronism in Resistant Hypertension: A Cohort Study","volume":"75","author":"Jaffe","year":"2020","journal-title":"Hypertension"},{"key":"B4","doi-asserted-by":"publisher","first-page":"162804","DOI":"10.4061\/2011\/162804","article-title":"Changes in the Perceived Epidemiology of Primary Hyperaldosteronism","volume":"2011","author":"Fagugli","year":"2011","journal-title":"Int J Hypertens"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijms20205214","article-title":"Endothelial Dysfunction in Primary Aldosteronism","volume":"20","author":"Chen","year":"2019","journal-title":"Int J Mol Sci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-020-00426-y","article-title":"Left Ventricular Remodeling and Dysfunction in Primary Aldosteronism","volume":"35","author":"Tsai","year":"2021","journal-title":"J Hum Hypertens"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.644260","article-title":"Composite Cardiovascular Outcomes in Patients With Primary Aldosteronism Undergoing Medical Versus Surgical Treatment: A Meta-Analysis","volume":"12","author":"Huang","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.798364","article-title":"Cerebro-Cardiovascular Risk, Target Organ Damage, and Treatment Outcomes in Primary Aldosteronism","volume":"8","author":"Lin","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.steroids.2014.08.016","article-title":"Effects of Aldosterone on Insulin Sensitivity and Secretion","volume":"91","author":"Luther","year":"2014","journal-title":"Steroids"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(92)90062-T","article-title":"In Vitro Effects of Insulin on Aldosterone Production in Rat Zona Glomerulosa Cells","volume":"50","author":"Petrasek","year":"1992","journal-title":"Life Sci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jcm8122194","article-title":"Effects of Primary Aldosteronism and Different Therapeutic Modalities on Glucose Metabolism","volume":"8","author":"Kwak","year":"2019","journal-title":"J Clin Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.13922","article-title":"Primary Aldosteronism Decreases Insulin Secretion and Increases Insulin Clearance in Humans","volume":"75","author":"Adler","year":"2020","journal-title":"Hypertension"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0450","article-title":"Increased Prevalence of Diabetes Mellitus and the Metabolic Syndrome in Patients With Primary Aldosteronism of the German Conn's Registry","volume":"173","author":"Hanslik","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.122002","article-title":"Fasting Plasma Glucose and Serum Lipids in Patients With Primary Aldosteronism: A Controlled Cross-Sectional Study","volume":"53","author":"Matrozova","year":"2009","journal-title":"Hypertension"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-013-1007-x","article-title":"Elevated Prevalence of Abnormal Glucose Metabolism in Patients With Primary Aldosteronism: A Meta-Analysis","volume":"183","author":"Chen","year":"2014","journal-title":"Ir J Med Sci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-015-1269-6","article-title":"Methodological Flaws in the Systematic Review and Meta-Analysis on Glucose Metabolism Disorders in Patients With Primary Aldosteronism","volume":"185","author":"Steichen","year":"2016","journal-title":"Ir J Med Sci"},{"key":"B17","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"Bmj"},{"key":"B18","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-A Web and Mobile App for Systematic Reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061","article-title":"The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2017.08.016","article-title":"Gender Differences in Glucose Homeostasis and Diabetes","volume":"187","author":"Mauvais-Jarvis","year":"2018","journal-title":"Physiol Behav"},{"key":"B21","doi-asserted-by":"publisher","first-page":"36725","DOI":"10.1038\/srep36725","article-title":"Ethnic Differences in Glucose Homeostasis Markers Between the Kyushu-Okinawa Population Study and the Framingham Offspring Study","volume":"6","author":"Ikezaki","year":"2016","journal-title":"Sci Rep"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3402\/mehd.v25.22857","article-title":"Higher Blood Glucose Level Associated With Body Mass Index and Gut Microbiota in Elderly People","volume":"25","author":"Sepp","year":"2014","journal-title":"Microb Ecol Health Dis"},{"key":"B23","doi-asserted-by":"crossref","DOI":"10.46658\/JBIMES-20-08","article-title":"Chapter 7: Systematic Reviews of Etiology and Risk","volume-title":"JBI Manual for Evidence Synthesis","author":"Moola S","year":"2020"},{"key":"B24","volume-title":"GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations Updated October (2013)","author":"Sch\u00fcnemann","year":"2013"},{"key":"B25","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1007\/s12020-020-02576-y","article-title":"Insulin Sensitivity and Pancreatic \u03b2-Cell Function in Patients With Primary Aldosteronism","volume":"72","author":"Grewal","year":"2021","journal-title":"Endocrine"},{"key":"B26","doi-asserted-by":"publisher","first-page":"6685469","DOI":"10.1155\/2021\/6685469","article-title":"Comparison of Clinical Features Between Primary Aldosteronism and Essential Hypertension in Chinese Patients: A Case-Control Study","volume":"2021","author":"Huang","year":"2021","journal-title":"Int J Endocrinol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/joim.13115","article-title":"Primary Aldosteronism: Higher Volume Load, Cardiac Output and Arterial Stiffness Than in Essential Hypertension","volume":"289","author":"Choudhary","year":"2021","journal-title":"J Intern Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s12902-020-00654-w","article-title":"High Body Fat Percentage is Associated With Primary Aldosteronism: A Cross-Sectional Study","volume":"20","author":"Manosroi","year":"2020","journal-title":"BMC Endocr Disord"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.2478\/jomb-2019-0035","article-title":"Biochemical and Clinical Characteristics of Patients With Primary Aldosteronism: Single Centre Experience","volume":"39","author":"Vuja\u010di\u0107","year":"2020","journal-title":"J Med Biochem"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.547356","article-title":"Associations Between Metabolic Profiles and Target-Organ Damage in Chinese Individuals With Primary Aldosteronism","volume":"11","author":"Zhang","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30367-4","article-title":"Cardiometabolic Outcomes and Mortality in Medically Treated Primary Aldosteronism: A Retrospective Cohort Study","volume":"6","author":"Hundemer","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2016.127","article-title":"Comparison of Left Ventricular Structure and Function in Primary Aldosteronism and Essential Hypertension by Echocardiography","volume":"40","author":"Yang","year":"2017","journal-title":"Hypertens Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1080\/10641963.2016.1182176","article-title":"Evaluation of Insulin Sensitivity and Secretion in Primary Aldosteronism","volume":"38","author":"Watanabe","year":"2016","journal-title":"Clin Exp Hypertens"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2013.09.009","article-title":"Primary Aldosteronism and Essential Hypertension: Assessment of Cardiovascular Risk at Diagnosis and After Treatment","volume":"24","author":"Turchi","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.01060","article-title":"Cardiovascular Complications Associated With Primary Aldosteronism: A Controlled Cross-Sectional Study","volume":"62","author":"Savard","year":"2013","journal-title":"Hypertension"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3934","article-title":"Aldosterone Excess Impairs First Phase Insulin Secretion in Primary Aldosteronism","volume":"98","author":"Fischer","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.5603\/EP.2013.0019","article-title":"Relationship Between Primary Aldosteronism and Obstructive Sleep Apnoea, Metabolic Abnormalities and Cardiac Structure in Patients With Resistant Hypertension","volume":"64","author":"Prejbisz","year":"2013","journal-title":"Endokrynol Pol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2010.65","article-title":"The Prevalence of Metabolic Syndrome and its Components in Two Main Types of Primary Aldosteronism","volume":"24","author":"Soml\u00f3ov\u00e1","year":"2010","journal-title":"J Hum Hypertens"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1246189","article-title":"Is Primary Aldosteronism Associated With Diabetes Mellitus? Results of the German Conn's Registry","volume":"42","author":"Reincke","year":"2010","journal-title":"Horm Metab Res"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2204","article-title":"Adipokines and Cardiometabolic Profile in Primary Hyperaldosteronism","volume":"95","author":"Iacobellis","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"B41","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.numecd.2009.03.007","article-title":"Metabolic Syndrome in Primary Aldosteronism and Essential Hypertension: Relationship to Adiponectin Gene Variants","volume":"20","author":"Ronconi","year":"2010","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1038\/ajh.2009.206","article-title":"Nonalcoholic Fatty Liver Disease in Primary Aldosteronism: A Pilot Study","volume":"23","author":"Fallo","year":"2010","journal-title":"Am J Hypertens"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3282861fa4","article-title":"A Possible Association Between Primary Aldosteronism and a Lower Beta-Cell Function","volume":"25","author":"Mosso","year":"2007","journal-title":"J\u00a0Hypertens"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2007.03.012","article-title":"Adiponectin and Insulin Sensitivity in Primary Aldosteronism","volume":"20","author":"Fallo","year":"2007","journal-title":"Am J Hypertens"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0736","article-title":"Insulin Sensitivity in Patients With Primary Aldosteronism: A Follow-Up Study","volume":"91","author":"Catena","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1733","article-title":"Prevalence and Characteristics of the Metabolic Syndrome in Primary Aldosteronism","volume":"91","author":"Fallo","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B47","article-title":"Can Primary Hyperaldosteronism be Considered as a Specific Form of Diabetes Mellitus","volume":"50","author":"Widimsk\u00fd","year":"2001","journal-title":"Physiol Res"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000001251","article-title":"Plasma Aldosterone Level Within the Normal Range is Less Associated With Cardiovascular and Cerebrovascular Risk in Primary Aldosteronism","volume":"35","author":"Murata","year":"2017","journal-title":"J\u00a0Hypertens"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015985","article-title":"Cardiovascular Risk in Primary Aldosteronism: A Systematic Review and Meta-Analysis","volume":"98","author":"Wu","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2011.06.014","article-title":"Mineralocorticoid Receptors in Vascular Function and Disease","volume":"350","author":"McCurley","year":"2012","journal-title":"Mol Cell Endocrinol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.ddmec.2007.12.005","article-title":"Mechanisms by Which Diabetes Increases Cardiovascular Disease","volume":"4","author":"Gleissner","year":"2007","journal-title":"Drug Discov Today Dis Mech"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.51.243","article-title":"Aldosterone Stimulates Gene Expression of Hepatic Gluconeogenic Enzymes Through the Glucocorticoid Receptor in a Manner Independent of the Protein Kinase B Cascade","volume":"51","author":"Yamashita","year":"2004","journal-title":"Endocr J"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2158-9","article-title":"Aldosterone Decreases Glucose-Stimulated Insulin Secretion In Vivo in Mice and in Murine Islets","volume":"54","author":"Luther","year":"2011","journal-title":"Diabetologia"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00662","article-title":"Abnormal Aldosterone Physiology and Cardiometabolic Risk Factors","volume":"61","author":"Vaidya","year":"2013","journal-title":"Hypertension"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1007\/s42000-019-00114-8","article-title":"The Relevance of Cortisol Co-Secretion From Aldosterone-Producing Adenomas","volume":"18","author":"Bhatt","year":"2019","journal-title":"Hormones (Athens)"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.1998.274.1.C25","article-title":"ATP-Sensitive K+ Channels in Pancreatic, Cardiac, and Vascular Smooth Muscle Cells","volume":"274","author":"Yokoshiki","year":"1998","journal-title":"Am J Physiol"},{"key":"B57","doi-asserted-by":"publisher","first-page":"796","DOI":"10.2337\/dc13-0598","article-title":"Body Composition is the Main Determinant for the Difference in Type 2 Diabetes Pathophysiology Between Japanese and Caucasians","volume":"37","author":"M\u00f8ller","year":"2014","journal-title":"Diabetes Care"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.870047\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T14:08:54Z","timestamp":1648735734000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.870047\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,31]]},"references-count":57,"alternative-id":["10.3389\/fendo.2022.870047"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.870047","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,31]]},"article-number":"870047"}}