Abstract | CONTEXT: Diagnosis of primary aldosteronism (PA) is made by screening, confirmation testing, and subtype diagnosis (computed tomography scan and adrenal vein sampling). However, some tests are costly and unavailable in most hospitals. OBJECTIVE: PATIENTS: INTERVENTION AND MAIN OUTCOME MEASURES: We measured s18OHB, s18OHF, and s18oxoF before and after saline load test (SLT) and 24-h u18OHF and u18oxoF. RESULTS: PA patients displayed significantly higher levels of s18OHB, u18OHF, and u18oxoF compared to EH and normal subjects; APA patients displayed s18OHB, u18OHF, and u18oxoF levels significantly higher than BAH patients. Similar results were obtained for s18OHF and s18oxoF. SLT significantly reduced s18OHB, s18OHF, and s18oxoF in all groups, but steroid reduction was much less for APA patients compared to BAH and EH. The s18OHB/ aldosterone ratio after SLT more than doubled in EH but remained unchanged in APA patients. CONCLUSIONS: u18OHF, u18oxoF, and s18OHB measurements in patients with a positive aldosterone/plasma renin activity ratio correlate with confirmatory tests and adrenal vein sampling in PA patients. If verified, these steroid assays would refine the diagnostic workup for PA.
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Authors | Paolo Mulatero, Stefania Morra di Cella, Silvia Monticone, Domenica Schiavone, Maria Manzo, Giulio Mengozzi, Franco Rabbia, Massimo Terzolo, Elise P Gomez-Sanchez, Celso E Gomez-Sanchez, Franco Veglio |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 97
Issue 3
Pg. 881-9
(Mar 2012)
ISSN: 1945-7197 [Electronic] United States |
PMID | 22238407
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- 18-oxocortisol
- 18-Hydroxycorticosterone
- 18-hydroxycortisol
- Hydrocortisone
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Topics |
- 18-Hydroxycorticosterone
(blood)
- Adult
- Humans
- Hydrocortisone
(analogs & derivatives, blood)
- Hyperaldosteronism
(blood, diagnosis)
- Hypertension
(blood, diagnosis)
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