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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

Authors

  • 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
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