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2; 95% confidence interval [CI], 2.7 to 10; P0.001) and conferred a 2.48-fold risk of insulin resistance after 1 year compared with surgery (95% CI, 1.3 to 4.8; P=0.007). Spironolactone treatment might increase insulin resistance in patients with PA. This strengthened the current recommendation that adrenalectomy is the preferred strategy for patient with positive lateralization test. Achieving a post-treatment PAC of 30 ng/dL for improved insulin sensitivity may be appropriate. Spironolactone treatment might increase insulin resis
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