Evidence map›Paper›PMID 41473246›Full record

ArticleFrontiers in endocrinology2025

Data-driven cluster analysis and external validation identify phenotypic subgroups in renin-independent aldosteronism with differential cardiovascular risk and therapeutic implications.

Yuqing Liu, Zhiheng Zhang, Haifeng Zhou, Yutong Yan, Mei Zhou, Cong Wang, Maoting Gao, Jun Tao, Meiling Bao, Tao Yang and 2 more

Abstract read
In one paragraph

Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yuqing Liu *Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Zhiheng Zhang *Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Haifeng ZhouDepartment of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Yutong YanDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Mei ZhouDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Cong WangDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Maoting GaoDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Jun TaoDepartment of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Meiling BaoDepartment of Pathology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Tao Yang *Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Min Sun *Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Yuhong Yang *Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Renin-independent aldosterone secretion contributes to aldosteronism and heightened cardiovascular risk, but renin-independent aldosteronism is highly heterogenous. A refined classification may assist in identifying individuals with distinct cardiovascular risk profiles and guide individualized treatment strategies. Methods: Unsupervised hierarchical clustering was performed using 12 clinical parameters from patients with renin-independent aldosteronism in our registry cohort (n=404). The cluster centroids derived from the discovery cohort were fixed and applied to the Framingham Heart Study Third Generation cohort (n=417) for subject classification. The identified clusters were evaluated for their association with cardiovascular outcomes, assessed by echocardiographic parameters, serum biomarkers and cardiovascular event rates. Results: Three replicable clusters of patients with renin-independent aldosteronism were identified. Patients in cluster 2 showed the most severe metabolic abnormalities with the highest lipid and glucose levels, while patients in cluster 3 displayed the highest aldosterone levels. Both clusters 2 and 3 showed elevated baseline blood pressure and left ventricular remodeling compared with cluster 1. Cluster 2 exhibited the highest risk of cardiovascular disease, chronic heart failure and atrial fibrillation, followed by cluster 3, which showed a higher incidence of cardiovascular disease compared with cluster 1. Conclusions: We identified 3 subgroups with differing degrees of target organ damage and cardiovascular risk. Our findings establish metabolic dysfunction, rather than aldosterone excess, as a potential dominant cardiovascular risk driver in RIA patients, defining a new risk paradigm. Patients with renin-independent aldosteronism with metabolic dysfunction or high aldosterone levels may benefit from mineralocorticoid receptor antagonists with different priorities for metabolic and cardiovascular protection. This new refined classification may help tailor optimal treatment strategies for patients with heterogenous renin-independent aldosteronism.

Indexed as

Cardiovascular DiseasesHyperaldosteronismReninAdultAgedAldosteroneBiomarkersCluster AnalysisCohort StudiesFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedPhenotypeRegistriesAldosteroneBiomarkersReninaldosteronecardiovascular diseaseclassificationrenin-independent aldosteronismrisk stratification

Identifiers

PMID41473246
PMCPMC12745265

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.