18-oxocortisol measurement in adrenal vein sampling as a biomarker for subclassifying primary aldosteronism.

Abstract

CONTEXT:

18-Oxocortisol (18-oxoF) is a derivative of cortisol (F) that is produced by aldosterone synthase (CYP11B2). The potential for this steroid as a biomarker for differentiating patients with aldosterone-producing adenoma (APA) from those with idiopathic hyperaldosteronism (IHA) has not been examined.

OBJECTIVES:

We measured 18-oxoF, aldosterone, and F in plasma from adrenal vein sampling (AVS) of patients with primary aldosteronism. We compared 18-oxoF levels and 18-oxoF/F ratios for their potential to differentiate APA from IHA.

DESIGN, SETTING, AND SUBJECTS:

This study measured 18-oxoF, F, and aldosterone in AVS obtained from patients with unilateral APA (14 cases) or bilateral IHA (seven cases, 14 samples total) using liquid chromatography-tandem mass spectrometry and RIA analyses.

RESULTS:

The levels of 18-oxoF and the ratios of 18-oxoF/F, before and after ACTH stimulation, were significantly higher in blood-draining APA than in those from the contralateral adrenal glands and from adrenal glands with IHA.

CONCLUSIONS:

The 18-oxoF levels and ratios of 18-oxoF/F in AVS samples can be a clinically useful biomarker for differentiating APA from IHA and for determining the localization or lateralization of APA in patients with primary aldosteronism.

• Authors: Yasuhiro Nakamura, Fumitoshi Satoh, Ryo Morimoto, Masataka Kudo, Kei Takase, Celso E Gomez-Sanchez, Seijiro Honma, Mitsunobu Okuyama, Kouwa Yamashita, William E Rainey, Hironobu Sasano, Sadayoshi Ito
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 96 Issue 8 Pg. E1272-8 (Aug 2011) ISSN: 1945-7197 [Electronic] United States
• PMID: 21593107 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• 18-oxocortisol
• Aldosterone
• Renin
• Hydrocortisone

Topics

• Adenoma (blood, diagnosis, surgery)
• Adrenal Gland Neoplasms (blood, diagnosis, surgery)
• Adrenal Glands (blood supply)
• Adrenalectomy
• Adult
• Aged
• Aldosterone (blood)
• Biomarkers (blood)
• Diagnosis, Differential
• Female
• Humans
• Hydrocortisone (analogs & derivatives, blood)
• Hyperaldosteronism (blood, classification, diagnosis)
• Male
• Middle Aged
• Renin (blood)
• Veins
• Young Adult