Obesity-Related Aldosteronism is Associated with Adverse Cardiac Structure, Function, and Adiposity
Bibliographic record
Abstract
Background: Obesity-related aldosteronism may increase risk for adverse cardiometabolic outcomes. We investigated the association between dysregulated aldosterone production and cardiac structure, function, and adiposity under controlled physiological conditions in obese hypertensive adults. Methods: Community-dwelling participants with overweight or obesity and stage 1-2 hypertension were prospectively enrolled to undergo comprehensive phenotyping of aldosterone production, along with cardiac and abdominal MRI. Aldosterone production was assessed via four controlled physiological maneuvers designed to assess both renin-independent aldosterone production: seated saline suppression testing (SST) and oral sodium loading (OSLT), and ACTH-modifiable aldosterone production: overnight dexamethasone suppression (DST), and adrenocorticotropic hormone (ACTH) stimulation. Cardiac structure and function, cardiac fat volume, hepatic fat content, and visceral-to-subcutaneous fat ratio were assessed by MRI. Results: 72 participants were enrolled, with a mean age of 55.2±9.5 years, a mean BMI of 37.8±5.3 kg/m², and of whom 68.1% were women. After SST, a continuum of non-suppressible and dysregulated aldosterone production was observed, with 29.2% of participants meeting criteria for overt primary aldosteronism. Greater post-SST aldosterone levels were independently associated with greater left ventricular mass index (p<0.001), left ventricular global longitudinal strain (p=0.038), cardiac fat volume (p=0.023), and visceral-to-subcutaneous fat ratio (p=0.003). These associations between dysregulated aldosterone production and cardiac remodeling and adipose-tissue parameters were consistently replicated under conditions of oral sodium loading and dexamethasone suppression and ACTH-stimulation. Conclusions: In obese adults with hypertension, dysregulated aldosterone production and overt primary aldosteronism are prevalent and independently associated with adverse cardiac remodeling and increased cardiometabolic adipose tissue volume. These findings highlight a potential pathophysiologic link between aldosterone excess and obesity-related cardiometabolic disease that should be investigated in interventional studies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".