[Primary hyperaldosteronism associated with... primary, secondary, or tertiary hyperparathyroidism?].
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Diagnosing primary aldosteronism, a hypertensive endocrine disease, is difficult because of an ill-defined frequency, various clinical forms and multiple diagnostic criteria. Current recommendations rest upon aldosterone and renin or renin activity determinations, the main point being to investigate aldosterone secretion with regards to of its main stimulus, renin. Proponents of the renin assay argue that it is easy and reliable. Proponents of the renin activity assay favour this method because of multiple epidemiological studies. Whatever the method used, each laboratory has to establish its critical thresholds in relation to the kits used. Extensive comparative studies would be useful to appreciate their relative benefits.
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In the present work we study the binding of insulin to its receptors in adipocytes from subcutaneous adipose tissue of left hypochondria extracted during an adrenalectomy carried out in a patient with Conn's Syndrome (left adrenal adenoma), comparing it to insulin binding to its receptors in adipocytes from subcutaneous adipose tissue of right hypochondria, obtained during a cholecystectomy because of cholelithiasis (controls). According to our results, there is an evident decrease in insulin binding to its receptors in adipocytes of the patient with Conn's Syndrome in relation to control group. This decrease in binding would be based both in a decrease in insulin receptor number as in an affinity loss of these receptors for the hormone. These facts at the receptor level could be originating a decrease in tissue response to insulin and be the base for glucose intolerance observed in patients with this pathology.
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