Leptin levels are suppressed in primary aldosteronism

Primary aldosteronism is associated with hypertension secondary to salt and water retention, hypokalemia and impaired insulin secretion with glucose i ntolerance in some patients. The secretion of leptin, a hormone produced by adipocytes, may be altered by reduced insulin secretion in primary aldoste ronism. We measured plasma leptin approximately 3 months before and 3 month s after curing of primary aldosteronism in 18 patients (12 male, 6 female, body mass index 29.1 +/- 4.4, mean +/- SD). Patients were treated by unilat eral laparoscopic adrenalectomy to remove an aldosterone-producing adenoma. There was a 46% postoperative increase in plasma leptin concentrations fro m 6.65 +/- 0.81 to 9.68 +/- 1.50 ng/ml (P = 0.004), despite a non-significa nt fall in body mass index. Plasma leptin was noted to increase after adren alectomy in 16 of the 18 patients. The patients also had improved blood pre ssure and a significant increase in plasma potassium post-operatively. It i s proposed that increased insulin secretory capacity associated with correc tion of negative potassium balance may account for the increase in plasma l eptin after curing primary aldosteronism. Further studies are indicated to identify the mechanism of plasma leptin suppression in primary aldosteronis m.