The aim of this study was to determine the relative contributions of fat mass and lean mass to the variability of bone mineral density (BMD) of the lumbar spine and proximal 1/3 forearm in Bulgarian women. 180 women aged 21 through 76 years participated (mean age 50.8 ± 9.7 years). 130 of them were postmenopausal. Lumbar spine and forearm BMD were measured by dual-energy X-ray absorptiometry, followed by a whole-body scan for body composition examination (Hologic QDR 4500 A device, software version 1.26). The strongest linear correlation was found with body weight (r2=0.231, p<0.001). Using this model, 18.1 % of the variability of lumbar spine BMD was attributable to fat mass and 16.0 % to lean mass. The relative influence of fat mass on L1-L4 BMD was greater than that of lean mass (standardized regression coefficient 0.291 versus 0.199). There were weak correlations of body weight, fat and lean mass with the forearm BMD. Lean mass correlated slightly better (r=0.187, p=0.050) to forearm BMD than fat mass (r=0.162, p=0.055). In conclusion, the differentiation between fat and lean mass does not strengthen the BMD correlations beyond that with total body weight.
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Primary aldosteronism (PA) has long been considered a rare disease, but a higher prevalence was suggested recently. The aim of this study was to evaluate the prevalence of PA in a group of Bulgarian hypertensive patients, including patients with adrenal incidentalomas (AI). The aldosterone to renin ratio (ARR)>750 was used as a positive screening test and the Captopril test was performed to confirm the diagnosis. Adrenal CT scan was used to differentiate between the main subtypes of PA- aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). The diagnosis of APA was retrospectively confirmed after surgery. After excluding other forms of endocrine hypertension, except PA, we investigated a total of 472 consecutive hypertensive patients, among them 96 patients with AI. Final diagnosis of PA was reached in 38 patients (8.05%) in the entire hypertensive population and in 12 patients (12.5%) among hypertensive patients with AI. In the group of PA, 15 patients (39.5%) were diagnosed with APA and 23 patients (60.5%) had an IHA. Among all patients with PA 21 (55.3 %) presented with hypokalemia. Our findings of a relatively high prevalence of PA support an early diagnosis of this potentially curable disease, especially in hypertensive patients with AI.
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