ObjectiveTo analyze the clinical characteristics and profile of lipid metabolism in patients with primary aldosteronism（PA）.MethodsThe clinical data wereretrospectively collected from 87 patients with PA confirmed by postoperative pathologicalexamination,of which 75 were adrenal cortical adenoma and 12 were cortical hyperplasia.Biochemical data, serum aldosterone（Ald）, adrenal imaging and efficacy were recorded, compared with the patients with essential hypertension（EH） and normotensives.Results(1)The levels of Ald in PA patients were（0.23±0.06）ng/mL and （0.21±0.06）ng/mL in upright and supine position respectively, which were higher than those of the patients in EH group significantly（P＜0.05）.Nevertheless, there were no significant difference between the adenoma and hyperplasia group（P＞0.05）.(2)93.1% of PA patients manifested with hypertension, among which 54.0% hypertensive was at level 3.(3)62.1% hypertensive were with hypokalemia.The level of serum potassium was significant lower in adenoma group\[3.19（2.56～3.83）mmol/L\] than in hyperplasia \[3.80（3.58～4.27）mmol/L\] and EH ones\[4.04（3.75～4.37）mmol/L\] (P<0.05), while the level of serum sodium in adenoma group\[（143.34±3.09）mmol/L\] was higher than those in hyperplasia group \[（140.87±2.08）mmol/L\] and EH group\[（142.12±2.22）mmol/L\](P＜0.05）.(4)The levels of triglyceride in adenoma group \[1.10（0.81～1.53）mmol/L\] were lower than those in hyperplasia and EH groups \[1.41(1.05~2.44) and 1.66(0.98~2.71), P<0.05\], while verylowdensity lipoprotein cholesterol（VLDLC）in adenoma group\[0.50（0.36～0.69）mmol/L\] were lower than in hyperplasia group\[0.64（0.48～1.11）mmol/L\] and EH group\[0.70（0.44～1.17）mmol/L, P<0.05\].Meanwhile, the level of highdensity lipoprotein cholesterol（HDLC） in adenoma group\[1.35（1.15～1.58）mmol/L\] was significantly higherthan those in hyperplasia group\[1.08（0.95～1.32）mmol/L\] and EH group\[1.24（0.97～1.43）mmol/L\](P＜0.05）.(5)Multifactor Logistic regression analysis showed that high VLDLC（OR=164.688）, high level of triglyceride（OR=15.740）were the predictors of adrenal cortical hyperplasia.Neverthless, hypokalemia（OR=0.103） and high level of serum sodium（OR=0.653） were the predictor of adrenocortical adenoma（P＜0.05, respectively）.(6)The blood pressure dropped significantly after laparoscopic adrenal neoplasm resection from the baseline of (178.29±30.53)/(102.53±16.88)mmHg to(133.99±16.36)/(82.60±10.70)mmHg(P＜0.01).ConclusionsThe patients with adrenal cortical adenoma were prone to be in a condition of hypokalaemia, while the patients with adrenal hyperplasia were susceptible to lipid metabolism disorders.Adrenal neoplasm resection is an effective method in lowering blood pressure in patients with PA.