Patients with primary aldosteronism have a higher risk of chronic kidney disease. Visceral fat tissue is hypothesized to stimulate the adrenal glands to overproduce aldosterone, and aldosterone promotes visceral fat tissue to produce inflammatory cytokines. However, it is unclear whether the volume of accumulated visceral fat tissue is associated with renal impairment among patients with hyperaldosteronism. We conducted a single-center cross-sectional study to assess the association between the estimated glomerular filtration rate and the ratio of the visceral-to-subcutaneous fat volume calculated by computed tomography. One hundred eighty patients with primary aldosteronism were enrolled. The mean ± SD age was 52.7 ± 11.0 years, and 60.0% were women. The ratio of visceral-to-subcutaneous fat volume was highly correlated with the estimated glomerular filtration rate (r = 0.49, p < 0.001). In multiple linear regression models, the ratio of visceral-to-subcutaneous fat tissue volume was significantly associated with the estimated glomerular filtration rate (estimates: −4.56 mL/min/1.73 m² per 1-SD), and there was an interaction effect between the plasma aldosterone concentration and the ratio of visceral-to-subcutaneous fat volume (p < 0.05). The group with a higher plasma aldosterone concentration exhibited a steeper decline in eGFR than the lower plasma aldosterone concentration group when the ratio increased. The ratio of visceral-to-subcutaneous fat tissue volume was an independent risk factor for renal dysfunction. This association increased in the presence of a high plasma aldosterone concentration. Clinicians should pay attention to the ratio of visceral-to-subcutaneous fat tissue volume and encourage primary aldosteronism patients to improve their lifestyle in addition to treating renin-aldosterone activity.

原发性醛固酮增多症患者患慢性肾病的风险更高。假设内脏脂肪组织刺激肾上腺过度产生醛固酮，醛固酮促进内脏脂肪组织产生炎性细胞因子。然而，尚不清楚积累的内脏脂肪组织的体积是否与醛固酮增多症患者的肾功能损害有关。我们进行了一项单中心横断面研究，以评估估计的肾小球滤过率与计算机断层扫描计算的内脏与皮下脂肪体积之比之间的关联。招募了 180 名原发性醛固酮增多症患者。平均 ± SD 年龄为 52.7 ± 11.0 岁，60.0% 为女性。r  = 0.49，p  < 0.001）。在多元线性回归模型中，内脏与皮下脂肪组织体积的比率与估计的肾小球滤过率显着相关（估计值：-4.56 mL/min/1.73 m²/1-SD），并且两者之间存在交互作用血浆醛固酮浓度和内脏与皮下脂肪体积之比 ( p < 0.05)。当比率增加时，血浆醛固酮浓度较高的组比血浆醛固酮浓度较低的组的 eGFR 下降幅度更大。内脏与皮下脂肪组织体积之比是肾功能不全的独立危险因素。这种关联在血浆醛固酮浓度高的情况下增加。临床医生应注意内脏与皮下脂肪组织体积的比例，鼓励原发性醛固酮增多症患者在治疗肾素-醛固酮活性的同时改善生活方式。