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Ozeki Y, Kinoshita M, Miyamoto S, Yoshida Y, Okamoto M, Gotoh K, Masaki T, Kambara K, Shibata H. Re-Assessment of the Oral Salt Loading Test Using a New Chemiluminescent Enzyme Immunoassay Based on a Two-Step Sandwich Method to Measure 24-Hour Urine Aldosterone Excretion. Front Endocrinol (Lausanne) 2022; 13:859347. [PMID: 35388294 PMCID: PMC8977523 DOI: 10.3389/fendo.2022.859347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/24/2022] [Indexed: 11/25/2022] Open
Abstract
Since April 2021, the plasma aldosterone concentration has been measured by chemiluminescent enzyme immunoassay (CLEIA) in Japan. In the present study, we developed a new CLEIA using a two-step sandwich method to measure the 24-hour urine aldosterone level. We collected 115 urine samples and measured 24-hour urine aldosterone levels employing radioimmunoassay (RIA), CLEIA, and liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results showed that the 24-hour urine aldosterone levels measured using CLEIA and LC-MS/MS were significantly correlated (ρ = 0.992, P < 0.0001). Based on the results of Passing-Bablok regression analysis, the slope was 0.992 and the intercept -19.3. The 24-hour urine aldosterone levels measured using CLEIA and RIA were also significantly correlated (ρ = 0.905, P < 0.0001). However, the aldosterone level measured by CLEIA was lower than that measured by RIA (slope, 0.729; intercept, 120.9). In Japan, a new guideline for primary aldosteronism has been announced, with changes in the aldosterone measurement method. The cutoff values for oral sodium loading test (OSLT) were changed, but clinical verification using real-world urine samples has not been performed. Therefore, we examined the cut-off value of the 24-hour urine aldosterone level after the OSLT. Receiver operating characteristic analysis revealed a cut-off value for primary aldosteronism of 3 μg/day.
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Affiliation(s)
- Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Mizuki Kinoshita
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Shotaro Miyamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kengo Kambara
- FUJIFILM Wako Pure Chemical Corporation, Amagasaki, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
- *Correspondence: Hirotaka Shibata,
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Yang J, Yu Y, Zhang Z, Wu Y, He Z. Adrenal venous sampling with adrenocorticotropic hormone stimulation: A meta-analysis. Int J Clin Pract 2021; 75:e14438. [PMID: 34096147 DOI: 10.1111/ijcp.14438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/24/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This meta-analysis was performed to compare the effect of adrenal venous sampling with adrenocorticotropic hormone with that without adrenocorticotropic hormone in subjects with primary aldosteronism. METHODS A systematic literature search up to May 2020 was performed and 17 studies were detected with 1878 subjects who had adrenal venous sampling operations. They reported relationships between with and without adrenocorticotropic hormone stimulation during adrenal venous sampling in subjects with primary aldosteronism. We calculated the odds ratio (OR) with 95% confidence intervals (CIs), using the dichotomous method with a random- or fixed-effect model. RESULTS Adrenal venous sampling operations with adrenocorticotropic hormone stimulation had statistically significant lower incorrect lateralisation (OR, 0.57; 95% CI, 0.43-0.75, P < .001); lower unsuccessful cannulations in both adrenal veins (OR, 0.35; 95% CI, 0.21-0.58, P < .001); lower unsuccessful cannulations of left adrenal vein (OR, 0.10; 95% CI, 0.06-0.17, P < .001) and lower unsuccessful cannulations of right adrenal vein (OR, 0.25; 95% CI, 0.11-0.54, P < .001) compared with without adrenocorticotropic hormone stimulation in subjects with primary aldosteronism. CONCLUSIONS Adrenal venous sampling operations with adrenocorticotropic hormone stimulation had significantly lower incorrect lateralisation, unsuccessful cannulations in both adrenal veins, unsuccessful cannulations of the left adrenal vein and unsuccessful cannulations of the right adrenal vein compared with adrenal venous sampling operations without adrenocorticotropic hormone stimulation in subjects with primary aldosteronism. Larger prospective studies are recommended to confirm these findings.
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Affiliation(s)
- Junfeng Yang
- Department of Urology, First People's Hospital of Yunnan Province, Kunming, China
| | - Yanhong Yu
- Department of Urology, First People's Hospital of Yunnan Province, Kunming, China
| | - Zhuorui Zhang
- Department of Urology, First People's Hospital of Yunnan Province, Kunming, China
| | - Yuerong Wu
- Department of Urology, First People's Hospital of Yunnan Province, Kunming, China
| | - Zhengyu He
- Department Of Urology, Yaan People's Hospital, Yaan, China
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Ozeki Y, Tanimura Y, Nagai S, Nomura T, Kinoshita M, Shibuta K, Matsuda N, Miyamoto S, Yoshida Y, Okamoto M, Gotoh K, Masaki T, Kambara K, Shibata H. Development of a New Chemiluminescent Enzyme Immunoassay Using a Two-Step Sandwich Method for Measuring Aldosterone Concentrations. Diagnostics (Basel) 2021; 11:diagnostics11030433. [PMID: 33806394 PMCID: PMC8001557 DOI: 10.3390/diagnostics11030433] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 01/04/2023] Open
Abstract
In the present study, we developed a new chemiluminescent enzyme immunoassay (CLEIA) using a two-step sandwich method to measure aldosterone concentrations. We investigated serum and plasma aldosterone concentrations in 75 blood samples from 27 patients using a radioimmunoassay (RIA) and the CLEIA (with current and newly improved reagents) as well as liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on the results of the Passing–Bablok regression analysis, the aldosterone levels measured using CLEIA with the new reagents and those measured by LC-MS/MS were found to be significantly correlated (slope, 0.984; intercept, 0.2). However, aldosterone levels varied depending on the measurement method (i.e., CLEIA with the new reagent, CLEIA with the current reagent, and RIA). Aldosterone levels were lower with the improved CLEIA method than with RIA and CLEIA using the current reagent. Therefore, the cutoff values of the screening test as well as those of the confirmatory test for primary aldosteronism (PA) should be adjusted to follow current clinical practice guidelines for PA. The formula that can be used to obtain the aldosterone level (pg/mL) when using CLEIA with the new reagent is 0.765 × RIA (pg/mL) − 33.7. This formula will enable PA cutoff values to be set for provisional screening and confirmatory tests.
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Affiliation(s)
- Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Yukie Tanimura
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Satoshi Nagai
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Takuya Nomura
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Mizuki Kinoshita
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Kanako Shibuta
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Naoki Matsuda
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Shotaro Miyamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
| | - Kengo Kambara
- FUJIFILM Wako Pure Chemical Corporation, Amagasaki City 661-0963, Hyogo, Japan;
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu City 879-5593, Oita, Japan; (Y.O.); (Y.T.); (S.N.); (T.N.); (M.K.); (K.S.); (N.M.); (S.M.); (Y.Y.); (M.O.); (K.G.); (T.M.)
- Correspondence: ; Tel.: +81-97-586-5793
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SİRKECİ Ö, ERKUŞ SİRKECİ E, TANOĞLU A. Severe hypokalemia and rhabdomyolysis caused by Conn syndrome. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.844053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sawamura T, Karashima S, Nagase S, Nambo H, Shimizu E, Higashitani T, Aono D, Ohbatake A, Kometani M, Demura M, Furukawa K, Takeda Y, Yoneda T. Effect of sodium-glucose cotransporter-2 inhibitors on aldosterone-to-renin ratio in diabetic patients with hypertension: a retrospective observational study. BMC Endocr Disord 2020; 20:177. [PMID: 33256676 PMCID: PMC7706199 DOI: 10.1186/s12902-020-00656-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 11/20/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Plasma aldosterone-to-renin ratio (ARR) is popularly used for screening primary aldosteronism (PA). Some medications, including diuretics, are known to have an effect on ARR and cause false-negative and false-positive results in PA screening. Currently, there are no studies on the effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors, which are known to have diuretic effects, on ARR. We aimed to investigate the effects of SGLT2 inhibitors on ARR. METHODS We employed a retrospective design; the study was conducted from April 2016 to December 2018 and carried out in three hospitals. Forty patients with diabetes and hypertension were administered SGLT2 inhibitors. ARR was evaluated before 2 to 6 months after the administration of SGLT2 inhibitors to determine their effects on ARR. RESULTS No significant changes in the levels of ARR (90.9 ± 51.6 vs. 81.4 ± 62.9) were found. Body mass index, diastolic blood pressure, heart rate, fasting plasma glucose, and hemoglobin A1c were significantly decreased by SGLT2 inhibitors. Serum creatinine was significantly increased. CONCLUSION SGLT2 inhibitor administration yielded minimal effects on ARR and did not increase false-negative results in PA screening in patients with diabetes and hypertension more than 2 months after administration.
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Affiliation(s)
- Toshitaka Sawamura
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
- Division Department of Diabetes and Endocrinology and Internal Medicine, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Fukui 910-8526 Japan
| | - Shigehiro Karashima
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Satoshi Nagase
- Department of Laboratory Sciences, Faculty of Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hidetaka Nambo
- School of Electrical, Information and Communication Engineering, College of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Eiko Shimizu
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Takuya Higashitani
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
- Division Department of Diabetes and Endocrinology and Internal Medicine, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Fukui 910-8526 Japan
| | - Daisuke Aono
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Azusa Ohbatake
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Mitsuhiro Kometani
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Masashi Demura
- Department of Hygiene, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Kenji Furukawa
- Health Care Center, Japan Advanced Institute of Science and Technology, 1-1 Asahidai, Nomi, Ishikawa 923-1292 Japan
| | - Yoshiyu Takeda
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Takashi Yoneda
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
- Division Department of Internal Medicine, Houju memorial hospital, 11-71 Midorigaoka, Nomi, Ishikawa 923-1226 Japan
- Institute of Liberal Arts and Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
- Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
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Aldosterone-Mediated Sodium Retention Is Reflected by the Serum Sodium to Urinary Sodium to (Serum Potassium) 2 to Urinary Potassium (SUSPPUP) Index. Diagnostics (Basel) 2020; 10:diagnostics10080545. [PMID: 32751768 PMCID: PMC7460433 DOI: 10.3390/diagnostics10080545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
The serum sodium to urinary sodium ratio divided by the (serum potassium)2 to urinary potassium ratio (SUSPPUP formula) reflects aldosterone action. We here prospectively investigated into the usefulness of the SUSPPUP ratio as a diagnostic tool in primary hyperaldosteronism. Parallel measurements of serum and urinary sodium and potassium concentrations (given in mmol/L) in the fasting state were done in 225 patients. Of them, 69 were diagnosed with primary aldosteronism (PA), 102 with essential hypertension (EH), 26 with adrenal insufficiency (AI) and 28 did not suffer from the above-mentioned disorders and were assigned to the reference group (REF). The result of the SUSPPUP formula was highest in the PA group (7.4, 4.2–12.3 L/mmol), followed by EH (3.2, 2.3–4.3 L/mmol), PA after surgery (3.9, 3.0–6.0 L/mmol), REF (3.4 ± 1.4 L/mmol) and AI (2.9 +/− 1.2 L/mmol). The best sensitivity in distinguishing PA from EH was reached by multiplication of the aldosterone to renin-ratio (ARR) with the SUSPPUP formula (92.7% at a cut off > 110 L/mmol), highest specificity was reached by the SUSPPUP determinations (87.2%). The integration of the SUSPPUP ratio into the ARR helps to improve the diagnosis of hyperaldosteronism substantially.
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Feasibility of Screening Primary Aldosteronism by Aldosterone-to-Direct Renin Concentration Ratio Derived from Chemiluminescent Immunoassay Measurement: Diagnostic Accuracy and Cutoff Value. Int J Hypertens 2019; 2019:2195796. [PMID: 31354984 PMCID: PMC6633965 DOI: 10.1155/2019/2195796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/08/2019] [Accepted: 06/13/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives Aldosterone-to-plasma renin activity ratio (ARR) derived from traditional radioimmunoassay (RIA) is widely used to detect primary aldosteronism (PA). Recently, aldosterone-to-direct renin concentration ratio (ADRR), which is calculated by direct renin concentration (DRC) measured by chemiluminescent immunoassay (CLIA), is proposed to replace ARR as the screening test method for PA. The purpose of the present study was to estimate the diagnostic accuracy and cutoff value of ADRR as screening test for PA. Methods 450 hypertensive patients with suspected PA referred to hypertension center of our department were enrolled and underwent screening and confirmatory tests of PA. Plasma renin activity (PRA), DRC, and plasma aldosterone concentration (PAC) were measured by both RIA and CLIA simultaneously during screening and confirmatory test. Results 386 patients were diagnosed as primary hypertension (PH) and 64 patients as PA. Within-patient correlation between PRA and DRC (r=0.88, P<0.001) and correlation between PAC measured by RIA and CLIA were high (r=0.80, P<0.001). The optimal cutoff value of ADRR was 2.93 (ng/dL)/(mU/L), sensitivity 80.33%, and specificity 92.11%. The optimal cutoff value of ARR was 25.28 (ng/dL)/(ng/mL/h), sensitivity 76.92%, and specificity 93.38%. Conclusion The optimal cutoff values of ADRR and ARR for screening PA are defined in this patient cohort with high sensitivity and specificity. Our results are of clinical importance for accelerating the extensive use of ADRR as a screening test for PA in daily practice.
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Laurent I, Astère M, Zheng F, Chen X, Yang J, Cheng Q, Li Q. Adrenal venous sampling with or without adrenocorticotropic hormone stimulation: A meta-analysis. J Clin Endocrinol Metab 2018; 104:5158213. [PMID: 30403797 DOI: 10.1210/jc.2018-01324] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/01/2018] [Indexed: 01/05/2023]
Abstract
CONTEXT Adrenal venous sampling (AVS) with or without adrenocorticotropic hormone (ACTH) stimulation is the test of choice to identify patients with a surgically curable subtype of primary aldosteronism (PA). Whether AVS with ACTH stimulation is more effective than AVS without ACTH stimulation remains controversial. OBJECTIVE To compare the effectiveness of AVS with ACTH stimulation and AVS without ACTH stimulation in patients with PA. METHODS The Cochrane Library, PubMed, Embase, and Web of Science databases were searched to identify relevant articles. All cohort studies comparing the 2 techniques (AVS with ACTH stimulation and AVS without ACTH stimulation in patient with PA) were included in the analysis. RESULTS A total of 14 studies met the inclusion criteria, and they were analyzed. AVS with ACTH stimulation did not significantly reduce the number of incorrect lateralization more than AVS without ACTH stimulation in patients with PA [OR: 0.76, 95% confidence interval (CI): 0.36, 1.59; P=0.47]. AVS with ACTH stimulation significantly reduced the number of unsuccessful cannulations of both adrenal veins more than AVS without ACTH stimulation in patients with PA (OR: 0.26, 95% CI: 0.17, 0.40; P<0.00001). For subgroup analyses, it also significantly reduced the number of unsuccessful cannulations of left adrenal vein and right adrenal vein (OR: 0.14, 95% CI: 0.06, 0.33; P<0.00001 and OR: 0.30, 95% CI: 0.12, 0.71; P=0.007, respectively). CONCLUSION AVS with ACTH stimulation can significantly reduce the number of unsuccessful cannulations, without significantly reducing the number of incorrect lateralization. Further studies are still needed to verify these findings.
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Affiliation(s)
- Irakoze Laurent
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University
- Kamenge military hospital, Ministry of Public Health and Fighting AIDS, Bujumbura, Burundi
| | - Manirakiza Astère
- Department of Oncology, First Affiliated Hospital of Chongqing Medical University
| | - Fengfan Zheng
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University
| | - Xiangjun Chen
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University
| | - Jun Yang
- Cardiovascular Endocrinology Laboratory, Hudson Institute of Medical Research, Australia
| | - Qingfeng Cheng
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University
| | - Qifu Li
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University
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