SUN-235 The Relationship Between Bilateral Primary Aldosteronism and Fib-4 Index

Abstract Disclosure: T. Ichijo: None. S. Goto: None. F. Kasahara: None. K. Ikehara: None. M. Higa: None. Primary aldosteronism (PA) accounts for approximately 10% of all patients with hypertension and is known to have a higher incidence of atherosclerotic cardiovascular disease compared with essential hypertension. Meanwhile, PA has been reported to be frequently complicated by metabolic dysfunction-associated steatotic liver disease (MASLD). In many literatures, a correlation between plasma aldosterone concentration (PAC) and visceral fat volume has been suggested in bilateral hyperaldosteronism (BHA), which is considered to account for most cases of idiopathic hyperaldosteronism. In this study, we investigated the possibility of liver fibrosis arising from MASLD. From February to November in 2024, we evaluated 48 patients who had been diagnosed with PA at our institution. Among them, we excluded 6 patients with HbA1c ≥6.5% and 5 patients with aldosterone-producing adenoma (APA), leaving 37 patients for analysis. We examined the correlation between their Fib-4 index and various PA-related parameters. The patients’ backgrounds were as follows (mean ± SD): age, 56.1 ± 10.3 years; 30 females; BMI, 25.1 ± 5.5; blood pressure, 149.7 ± 25.5 / 90.6 ± 15.4 mmHg; serum K, 4.0 ± 0.3 mM; PAC, 106.6 ± 56.3 pg/mL; active renin concentration (ARC), 2.74 ± 2.64 pg/mL; aldosterone-renin ratio (ARR), 54.1 ± 32.2; and Fib-4 index, 1.15 ± 0.45. Correlation analysis of the Fib-4 index with each PA parameter revealed significant positive correlations with BMI (r=0.68, p=0.0001) and ARR (r=0.55, p=0.0005), and a significant negative correlation with ARC (r=-0.44, p=0.0070). Previous reports have also pointed to associations of hepatic steatosis with bilateral PA and of visceral fat with PAC. Based on our findings, we suggest some possibility about progression from steatosis to liver fibrosis. In conclusion, our results suggest that patients with bilateral PA may have an increased risk of liver fibrosis and that autonomously elevated aldosterone secretion could promote the progression of liver fibrosis. Presentation: Sunday, July 13, 2025