OR29-1 The Association of Aldosterone and Endothelin-1 With Incident Diabetes Among African Americans: The Jackson Heart Study

INTRODUCTION: African Americans (AAs) have the highest prevalence of hypertension among United States racial/ethnic groups. Regulators of blood pressure, such as aldosterone and endothelin-1 (ET-1), increase risk of hypertension. Higher aldosterone levels have been associated with higher insulin resistance and increased risk of diabetes. Similarly, ET-1 is known to cause insulin resistance by reducing glucose uptake. However, it is poorly understood how aldosterone and ET-1, which primarily regulate the blood pressure, together are involved in diabetes pathophysiology among AAs. AIM: To examine the individual and combined longitudinal associations of aldosterone and ET-1 with incident diabetes among AAs in the Jackson Heart Study (JHS). METHODS: Among 3,914 AA participants without prevalent diabetes in the JHS, linear regression models were used to examine cross-sectional associations of exposures (aldosterone, endothelin-1, and a combined aldosterone-endothelin-1 score [2–8]) with glycemic measures (fasting plasma glucose [FPG], HbA1c, HOMA-IR, and HOMA-β). Longitudinal associations of exposures with incident diabetes were examined using Cox proportional hazard models. Models were adjusted for age, sex, education, occupation, systolic blood pressure, smoking, physical activity, dietary intake, alcohol use and adiponectin. RESULTS: Aldosterone and the combined aldosterone-endothelin score were positively associated with FPG, HOMA-IR, and HOMA-β. Endothelin-1 was negatively associated with FPG but positively associated with HOMA-β. Only the aldosterone-endothelin score was positively associated with HbA1c. A 1-SD higher serum aldosterone and endothelin-1 were associated with a 22% and 14% higher risk of incident diabetes, respectively, while a 1-point higher aldosterone-endothelin score was associated with a 13% higher risk of incident diabetes after adjustment for diabetes risk factors. CONCLUSIONS: The study indicates both aldosterone and ET-1 are risk factors for the development of diabetes among AAs, thus future studies should consider aldosterone and ET-1 modulation to improve glucose metabolism. Presentation: Tuesday, June 14, 2022 9:45 a.m. - 10:00 a.m.