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Horm Metab Res 2016; 48(07): 440-445
DOI: 10.1055/s-0042-103588
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Enhanced Soluble Serum CD40L and Serum P-Selectin Levels in Primary Aldosteronism

L. Petramala
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
G. Iacobellis
2   Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
,
R. Carnevale
3   Department of Internal Medicine and Medical Specialties, University of Rome “Sapienza”, Rome, Italy
,
C. Marinelli
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
L. Zinnamosca
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
A. Concistrè
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
M. Galassi
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
G. Iannucci
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
P. Lucia
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
,
P. Pignatelli
3   Department of Internal Medicine and Medical Specialties, University of Rome “Sapienza”, Rome, Italy
,
A. Ciardi
4   Department of Surgery “Pietro Valdoni”, University of Rome “Sapienza”, Rome, Italy
,
F. Violi
3   Department of Internal Medicine and Medical Specialties, University of Rome “Sapienza”, Rome, Italy
,
G. De Toma
4   Department of Surgery “Pietro Valdoni”, University of Rome “Sapienza”, Rome, Italy
,
C. Letizia
1   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Specialized Center of Secondary Hypertension, University of Rome “Sapienza”, Rome, Italy
› Author Affiliations
Further Information

Publication History

received 23 November 2015

accepted 15 February 2016

Publication Date:
21 April 2016 (online)

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Abstract

Primary aldosteronism (PA) is one of the most frequent forms of secondary hypertension, associated with atherosclerosis and higher risk of cardiovascular events. Platelets play a key role in the atherosclerotic process. The aim of the study was to evaluate the platelet activation by measuring serum levels of soluble CD40L (sCD40L) and P-selectin (sP-selectin) in consecutive PA patients [subgroup: aldosterone-secreting adrenal adenoma (APA) and bilateral adrenal hyperplasia (IHA)], matched with essential hypertensive (EH) patients. The subgroup of APA patients was revaluated 6-months after unilateral adrenalectomy. In all PA group, we measured higher serum levels of both sP-selectin (14.29±9.33 pg/ml) and sCD40L (9.53±4.2 ng/ml) compared to EH patients (9.39±5.3 pg/ml and 3.54±0.94 ng/ml, respectively; p<0.001). After removal of APA, PA patients showed significant reduction of blood pressure (BP) values, plasma aldosterone (PAC) levels and ARR-ratio, associated with a significant reduction of sP-selectin (16.74±8.9 pg/ml vs. 8.1±3.8 pg/ml; p<0.01) and sCD40L (8.6±1 ng/ml vs. 5.24±0.94 ng/ml; p<0.001). In PA patients, we found a significant correlation between sP-selectin and sCD40L with PAC (r=0.52, p<0.01; r=0.50, p<0.01, respectively); this correlation was stronger in APA patients (r=0.54; p<0.01 r=0.63; p<0.01, respectively). Our results showed that PA is related to platelet activation, expressed as higher plasma values of sCD40L and sP-selectin values. Surgical treatment and consequent normalization of aldosterone secretion was associated with significant reduction of sCD40L and sP-selectin values in APA patients.

Key words

primary aldosteronism - platelet activation - CD40 - p-selectin
 

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