Serum 18-hydroxycortisol in primary aldosteronism, hypertension, and normotensives.

Abstract

This study reports the determination of plasma 18-hydroxycortisol (18-OHF) using a new and easy enzyme-linked immunosorbent assay (ELISA) method in primary aldosteronism and compares the values found in essential hypertensives and normotensive controls. In primary aldosteronism, we evaluated usefulness of plasma 18-OHF determination and the dexamethasone suppression test in the diagnosis of glucocorticoid-remediable aldosteronism using the genetic test as the gold standard. We studied 31 primary aldosteronism patients, 101 essential hypertensives, and 102 healthy normotensive controls. The plasma 18-OHF was measured using a biotin-avidin enzyme-linked assay by a new and purified polyclonal antibody. The 18-OHF value in primary aldosteronism was 6.3+/-8.05 nmol/L; this value is significantly higher than the value found in essential hypertensives and normotensive controls (2.81+/-1.42 and 2.70+/-1.41 nmol/L, respectively; P<0.0005). In primary aldosteronism, 4 of 31 patients had 18-OHF levels that were 10 times higher than the normal upper limit (2.983 nmol/L). The dexamethasone suppression test in primary aldosteronism patients was positive (serum aldosterone <4 ng/dL) in 13 of 31 cases. A chimeric CYP11B1/CYP11B2 gene was demonstrated in 4 primary aldosteronism patients, corresponding to the same cases that had higher level of 18-OHF. In conclusion, plasma 18-OHF determination by this ELISA method is reliable for detecting glucocorticoid-remediable aldosteronism, and it does so better than the dexamethasone suppression test.

• Authors: L Mosso, C E Gómez-Sánchez, M F Foecking, C Fardella
• Journal: Hypertension (Dallas, Tex. : 1979) (Hypertension) Vol. 38 Issue 3 Pt 2 Pg. 688-91 (Sep 2001) ISSN: 1524-4563 [Electronic] United States
• PMID: 11566957 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Cytochrome P-450 CYP11B2
• Steroid 11-beta-Hydroxylase
• 18-hydroxycortisol
• Hydrocortisone

Topics

• Adult
• Cytochrome P-450 CYP11B2 (genetics)
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Hydrocortisone (analogs & derivatives, blood)
• Hyperaldosteronism (blood, genetics)
• Hypertension (blood, genetics)
• Male
• Middle Aged
• Steroid 11-beta-Hydroxylase (genetics)