Post-Saline Infusion Plasma Aldosterone Concentrations are Well Correlated with the Lateralized Ratio of Adrenal Venous Sampling in Patients of Primary AldosteronismYuko Tsushima1,2, Ken Terui1,2*, Koshi Makita1,2, Yuko Asari1,2, Noriko Ishigame1,2, Yuki Nakada1,2, Aya Sugiyama1,2, Shingo Murasawa1,2, Satoshi Yamagata1,2, Yutaka Watanuki1,2, Shinobu Takayasu1,2, Takeshi Nigawara1,2, Kazunori Kageyama1,2 and Makoto Daimon1,2
- Corresponding Author:
- Ken Terui
Department of Endocrinology and Metabolism
Hirosaki University Graduate School of Medicine
5 Zaifu-cho, Hirosaki, Japan
E-mail: [email protected]
Received Date: July 04, 2017; Accepted Date: July 10, 2017; Published Date: July 12, 2017
Citation: Tsushima Y, Terui K, Makita K, Asari Y, Ishigame N, et al. (2017) Post-Saline Infusion Plasma Aldosterone Concentrations are Well Correlated with the Lateralized Ratio of Adrenal Venous Sampling in Patients of Primary Aldosteronism. J Steroids Horm Sci 8:186. doi:10.4172/2157-7536.1000186
Copyright: © 2017 Tsushima Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Adrenal venous sampling (AVS) is the most reliable test to distinguish between unilateral and bilateral primary aldosteronism (PA). However, AVS is invasive, risky, and expensive, and alternative diagnostic methods are desirable. This study aimed to investigate the diagnostic power of saline infusion test (SIT) to distinguish between unilateral and bilateral PA.
Design: Retrospective database analysis.
Subjects and Methods: We selected 111 patients with PA diagnosed by confirmatory tests who underwent both SIT and successful AVS. Thirty-two patients had lateralized ratio (LR) over 4.0 and 79 patients had LR less than 4.0. Multiple regression analysis and receiver operating characteristic (ROC) analysis were used to examine whether the SIT had good diagnostic power to distinguish between patients with high LR and those with low LR.
Results: The patients with high LR had significantly lower serum potassium levels (P<0.0001, Mann-Whitney’s U Test) and higher plasma aldosterone concentrations after SIT (Post-PAC) (P<0.0001). It was revealed that Post-PAC levels were independently associated with the LR by multiple regression analysis (P=0.0112). ROC analysis revealed that the diagnostic accuracy of SIT was very high for distinguishing between patients with high LR and those with low LR. The optimal cut-off value of Post-PAC for the diagnosis of patients with low LR was less than 9.3 ng/dl.
Conclusions: SIT is useful for distinguishing between patients with high LR and low LR. It might be possible to omit AVS in patients with a Post-PAC value less than 9.3 ng/dl.Combining the results of serum potassium levels and imaging examinations with SIT might be a potential strategy for PA subtypes.