Comprehensive Analysis of Steroid Biomarkers for Guiding Primary Aldosteronism Subtyping

Adrenal vein sampling (AVS) is required to distinguish unilateral from bilateral aldosterone sources in primary aldosteronism (PA), and cortisol is used for AVS data interpretation, but cortisol has several pitfalls. In this study, we present the utility of several other steroids in PA subtyping, bo...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2020-01, Vol.75 (1), p.183-192
Main Authors: Turcu, Adina F., Wannachalee, Taweesak, Tsodikov, Alexander, Nanba, Aya T., Ren, Jianwei, Shields, James J., O’Day, Patrick J., Giacherio, Donald, Rainey, William E., Auchus, Richard J.
Format: Article
Language:English
Subjects:
Adrenal Glands - blood supply
Adult
Aged
Aldosterone - blood
Biomarkers - blood
Female
Humans
Hydrocortisone - blood
Hyperaldosteronism - blood
Hyperaldosteronism - diagnosis
Male
Mass Spectrometry
Middle Aged
Veins
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Summary:Adrenal vein sampling (AVS) is required to distinguish unilateral from bilateral aldosterone sources in primary aldosteronism (PA), and cortisol is used for AVS data interpretation, but cortisol has several pitfalls. In this study, we present the utility of several other steroids in PA subtyping, both during AVS, as well as in peripheral serum. We included patients with PA who underwent AVS at University of Michigan between 2012 and 2018. We used mass spectrometry to simultaneously quantify 17 steroids in adrenal veins (AV) and periphery, both at baseline and after cosyntropin administration. PA was classified as unilateral or bilateral based on a lateralization index ≥ or
ISSN:0194-911X
1524-4563
DOI:10.1161/HYPERTENSIONAHA.119.13866