Low-grade Cortisol Cosecretion Has Limited Impact on ACTH-stimulated AVS Parameters in Primary Aldosteronism.
J Clin Endocrinol Metab
; 105(10)2020 10 01.
Article
in En
| MEDLINE
| ID: mdl-32785656
ABSTRACT
CONTEXT In primary aldosteronism, cosecretion of cortisol may alter cortisol-derived adrenal venous sampling indices. OBJECTIVE:
To identify whether cortisol cosecretion in primary aldosteronism alters adrenal venous sampling parameters and interpretation.DESIGN:
Retrospective case-control study.SETTING:
A tertiary referral center. PATIENTS 144 adult patients with primary aldosteronism who had undergone both adrenocorticotropic hormone-stimulated adrenal venous sampling and dexamethasone suppression testing between 2004 and 2018. MAIN OUTCOMEMEASURES:
Adrenal venous sampling indices including adrenal vein aldosterone/cortisol ratios and the selectivity, lateralization, and contralateral suppression indices.RESULTS:
21 (14.6%) patients had evidence of cortisol cosecretion (defined as a failure to suppress cortisol to ≤50 nmol/L post dexamethasone). Patients with evidence of cortisol cosecretion had a higher inferior vena cava cortisol concentration (Pâ =â .01) than those without. No difference was observed between the groups in terms of selectivity index, lateralization index, lateralization of aldosterone excess, or adrenal vein cannulation rate.CONCLUSIONS:
Cortisol cosecretion alters some parameters in adrenocorticotrophic hormone-stimulated adrenal venous sampling but does not result in alterations in patient management.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Hydrocortisone
/
Adrenal Glands
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Adrenocorticotropic Hormone
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Aldosterone
/
Hyperaldosteronism
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Clin Endocrinol Metab
Year:
2020
Type:
Article
Affiliation country:
United kingdom