Abstract 281: Measurement of Peripheral Blood 18-oxo-cortisol Can Differentiate the Patients With Aldosterone Producing Adenoma From Those With Essential Hypertension. -omitting many steps of diagnostic workup-
Backgrounds: Primary aldosteronism (PA) is diagnosed and treated by the long steps, such as screening, confirmation testing and subtype diagnosis (computed tomography (CT) scan and adrenal venous sampling (AVS)).
Objective: The aim of the study was to determine the role of peripheral plasma levels of 18-oxo-cortisol (p18oxoF) in discriminating aldosterone producing adenoma (APA), which is a major surgically curable subtype of PA, from essential hypertension (EH) which should be medically treated.
Patients: The study included 79 EH patients with the aldosterone/renin activity ratio (ARR) of 9.0±0.5 (ng/dl per ng/ml/h) and 87 patients with CT-positive macro APA (ARR: 363±38.7).
METHODS: All the unilateral APA patients diagnosed by AVS were surgically proven and histopathologically confirmed including immunohistochemical analysis of steroidogenic enzymes. We measured p18oxoF of all patients by high sensitive LC ms/ms.
Results: APA patients showed significantly higher levels of p18oxoF and compared to EH patients. Especially, the ROC analysis of 18oxoF in CT-positive macro APA versus EH demonstrated clinically significant discrimination with higher sensitivity of 0.81 and higher specificity of 0.97 by cutoff value of 4.6 ng/dl.
Conclusions: Peripheral plasma levels of 18-oxo-cortisol can practically differentiate the patients with APA from those with essential hypertension omitting many steps of diagnostic workup for PA.
- © 2012 by American Heart Association, Inc.