Measurement of 18-hydroxycorticosterone during adrenal vein sampling for primary aldosteronism.
J Clin Endocrinol Metab
; 92(7): 2648-51, 2007 Jul.
Article
em En
| MEDLINE
| ID: mdl-17473070
ABSTRACT
CONTEXT In primary aldosteronism, elevated serum 18-hydroxycorticosterone (18OHB) suggests aldosterone-producing adenoma (APA) rather than bilateral, idiopathic hyperaldosteronism (IHA), but little is known about the relative production of 18OHB and aldosterone (A) in APAs compared with IHA. OBJECTIVES:
We measured 18OHB, A, and cortisol (F) in blood from adrenal vein sampling (AVS) studies. We compared the discriminatory power of gradients in 18OHB/A and 18OHB/F ratios with A/F ratio gradients for distinguishing APA from IHA. DESIGN, SETTING, ANDSUBJECTS:
We measured 18OHB and A in excess serum from 23 AVS studies performed at our university hospitals. MAIN OUTCOMEMEASURES:
We calculated the ratios 18OHB/A, 18OHB/F, and A/F for all specimens, and determined the adrenal vein gradients for these ratios.RESULTS:
The 18OHB/A ratios were much lower in blood draining APAs (2.17 +/- 0.62) than in blood draining the contralateral adrenals (12.96 +/- 12.76; P < 0.001) but similar to blood draining IHA adrenals (4.69 +/- 4.32; P = 0.02). In contrast, the 18OHB/F ratios were elevated in specimens from APAs (26.03 +/- 11.51) compared with IHA adrenals (9.22 +/- 5.18; P < 0.001) or the contralateral adrenals (6.23 +/- 2.97; P < 0.001). Using 18OHB/F gradient greater than two or 18OHB/A gradient less than 0.5 as criteria for lateralization, interpretations agreed with lateralizations based on A/F gradients in 21 of 23 cases.CONCLUSIONS:
High serum 18OHB in APA reflects augmented production of both 18OHB and A, not disproportionate 18OHB secretion relative to A. The 18OHB/A and 18OHB/F gradients are useful adjuncts but not as reliable as A/F gradients for A lateralization during AVS.
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Bases de dados:
MEDLINE
Assunto principal:
Glândulas Suprarrenais
/
18-Hidroxicorticosterona
/
Hiperaldosteronismo
Tipo de estudo:
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos