18-Hydroxycorticosterone as a Marker for Primary Hyperaldosteronism

Lapworth, Ruth; Short, Frances; James, V. H. T.

doi:10.1177/000456328902600303

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…This suggested that this corticosteroid may be used to diagnose the etiology of primary aldosteronism (9,19), but this view was not supported by others (20). This suggested that this corticosteroid may be used to diagnose the etiology of primary aldosteronism (9,19), but this view was not supported by others (20).…”

Section: Discussionmentioning

confidence: 95%

Urinary excretion of 19-noraldosterone, 18, 19-dihydroxycorticosterone and 18-hydroxy-19-norcorticosterone in patients with aldosterone-producing adenoma or idiopathic hyperaldosteronism

Takeda

Miyamori²,

Iki³

et al. 1992

Acta Endocrinologica

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8-OH-F) and aldosterone were measured in 25 patients with primary aldosteronism, 16 with an aldosterone-producing adenoma and 9 with idiopathic hyperaldosteronism. In patients with idiopathic hyperaldosteronism, urinary 19-noraldosterone (207\m=+-\51pmol/day), 18, 19(OH)2-B (21 \ m=+-\ 4.2 nmol/day) and 18-OH-19-nor-B (879 \ m=+-\ 21 3 pmol/day) levels were lower but not significantly different from 19-noraldosterone (263\m=+-\56pmol/day), 18, 19(OH)2-B (40\m=+-\8.7nmol/day) and 18-OH-19-nor-B (1322\m=+-\267pmol/day) seen in patients with aldosterone-producing adenoma. Urinary aldosterone did not differ significantly between patients with idiopathic hyperaldosteronism and those with aldosterone-producing adenoma. Both urinary 18-OH-B and 18-OH-F excretion were significantly higher in aldosterone-producing adenoma (39\m=+-\5.2nmol/day, 1660\m=+-\318nmol/day, respectively) compared with patients with idiopathic hyperaldosteronism (19\m=+-\3.3nmol/day, 541 \m=+-\93 nmol/day. respectively) (p<0.05). Though urinary 18-OH-F and 18-OH-B concentrations were useful markers, the mineralocorticoid steroids which we can only now measure, 19\ x=req-\ noraldosterone, 18, 19(OH)2-B and 18-OH-19-nor-B, could not be used to distinguish the two subsets of primary aldosteronism.

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Section: Discussionmentioning

confidence: 95%

Urinary excretion of 19-noraldosterone, 18, 19-dihydroxycorticosterone and 18-hydroxy-19-norcorticosterone in patients with aldosterone-producing adenoma or idiopathic hyperaldosteronism

Takeda

Miyamori²,

Iki³

et al. 1992

Acta Endocrinologica

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“…Biglieri und Schambelan (14) fanden bei 23 Patienten mit primärem Hyperaldosteronismus (bei 5 infolge eines Nebennierenrinden-Adenoms), daß die Bestimmung des Plasma-18-OH-Corticosterons scharf zwischen den Patientengruppen trennen kann. Diese Ergebnisse konnten von anderen Autoren (auch bei Plasma-Bestimmung) nicht bestätigt werden (1,23). Unsere Auswertung an einem repräsentativen Patientenkollektiv läßt erkennen, daß einerseits in 7% der Adenom-Fälle Normalwerte und andererseits bei 17,3% der Hyperplasie-Fälle leicht bis mäßig erhöhte 18-OH-Corticosteron-Werte gefunden werden können.…”

Section: Tab 3b: Varianzanalyse Zur Ermittlung Der Trenneigenschafteunclassified

“…Auch andere Autoren fanden in kleineren Kollektiven bzw. vereinzelten Beobachtungen vergleichbare Ergebnisse (1,23). Eine normale 18-OH-Corticosteron-Ausscheidung bei Patienten mit Nebennierenrinden-Adenom kann Ausdruck einer veränderten Metabolisierung sein, derart, daß genügend Enzyme vorhanden sein müssen, die 18-OH-Corticosteron in Aldpsteron umwandeln, oder aber, daß Adenome zum Teil auch über alternative Biosynthesewege Aldosteron bilden können unter Umgehung von 18-OH-Corticosteron (24).…”

Section: Tab 3b: Varianzanalyse Zur Ermittlung Der Trenneigenschafteunclassified

Untersuchungen zum diagnostischen Stellenwert der Aldosteron-Vorstufe 18-Hydroxycorticosteron in der Diagnose und Differentialdiagnose des primären Hyperaldosteronismus

Abdelhamid¹,

Thomas²,

Nensel³

et al. 1994

LaboratoriumsMedizin

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Lab.med. 18:275(1994) 275 Brought to you by | University of Arizona Authenticated Download Date | 7/13/15 5:36 AM Orlginalie Schlüsselwörter: 18-Hydroxycorticosteron -Tetrahydro-Aldosteron -primärer Hyperaldosteronismus -Nebennierenrinden-Adenom -Nebennierenrinden-Hyperplasie Summary:18 is considered to be the immediate precursor o f aldosterone. In vitro studies and few clinical observations show that adrenal adenomas (associated with primary aldosteronism), in contrast to adrenal hyperplasia, produce increased amounts of 18 OH-B. In this study the diagnostic value of 18 OH-B was compared with that ofthe aldosterone metabolites aldosterone-18-glucuronide (ALD-18-G) and tetrahydroaldosterone (TH-ALD) in regard to recognition of primary aldosteronism and differential diagnosis of adenomas and hyperplasia. 1,272 outpatients with hypertension were studied, whereby the diagnosis of primary aldosteronism could be confirmed, in 84 patients due to adrenal adenomas and in 1 10 patients due to adrenal hyperplasia. A diagnostic sensitivity of 99.2% and a diagnostic specificity of 95.2% was calculated for 18 OH-B when differentiating primary aldosteronism due to adenomas from essential hypertension. This was markedly Iower when differentiating between primary aldosteronism due to hyperplasia and essential hypertension; the diagnostic sensitivity here was 79.7% and the diagnostic specificity 60.9% Furthermore, in 1 1 ofthe 84 adenoma cases and in 5 ofthe 1 10 hyperplasia cases 18 OH-B was at first the only elevated steroid. Only over an observation period of up to two years could a slow increase in the aldosterone metabolites be observed in these patients. Thus, 18 OH-B is an "early maker" for primary aldosteronism.

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“…As a result, the need for reliable biochemical indicators is urgent. Several endogenous biomarkers had been studied to reduce AVS, including urinary 18‐hydroxycortisol (18‐OHF) 9–13 . 18‐OHF is a hybrid steroid produced by the adrenal gland, which was discovered in the urine of a PA patient in 1982 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Several endogenous biomarkers had been studied to reduce AVS, including urinary 18‐hydroxycortisol (18‐OHF). 9 , 10 , 11 , 12 , 13 18‐OHF is a hybrid steroid produced by the adrenal gland, which was discovered in the urine of a PA patient in 1982. 14 Urinary 18‐OHF is low in healthy subjects, essential hypertensives, and PA patients with IHA but significantly increased in PA patients with APA and familial hyperaldosteronism.…”

Section: Introductionmentioning

confidence: 99%

A dilute‐and‐shoot liquid chromatography–tandem mass spectrometry method for urinary 18‐hydroxycortisol quantification and its application in establishing reference intervals

Zhao

Bian

Rao

et al. 2022

Clinical Laboratory Analysis

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Background Eighteen‐hydroxycortisol (18‐OHF) is a potential biomarker for differential diagnosis of the two major primary aldosteronism subtypes, aldosterone‐producing adenoma, and idiopathic hyperaldosteronism. Methods Urine samples were processed, and the 18‐OHF in urine samples were successfully quantified by in‐house established dilute‐and‐shoot liquid chromatography–tandem mass spectrometry (LC–MS/MS) method. Separation was accomplished on a Sigma Ascentis Express C18 column with a gradient mixture of phase (A) 0.2% formic acid in water and phase (B) 0.2% formic acid in methanol at a flow rate of 0.4 ml/min. Mass spectrometric detection was performed in positive electrospray ionization mode via a mass spectrometer. Results The linearity of urinary 18‐OHF ranged from 4.28 to 8.77 × 103 nmol/L, with a lower limit of quantification at 4.28 nmol/L. The intra‐ and inter‐precision were both below 3%. The range of analytical recovery was 97.8%–109.2%. The validated dilute‐and‐shoot LC–MS/MS method was compared with the SPE LC–MS/MS method modified from the one reported in 2013. The results by Passing–Bablok regression analysis and Bland–Altman plotting demonstrated a good agreement between the two methods. The presented method was then applied to establish sex‐specific reference intervals from 62 males and 62 females, respectively. The calculated 2.5%–97.5% reference intervals for 24‐h urinary 18‐OHF were 113–703 nmol/day for males and 71.2–450 nmol/day for females. Conclusion The presented dilute‐and‐shoot LC–MS/MS method for 18‐OHF quantification showed a good performance in the clinical application. Furthermore, the sex‐specific reference intervals for 24‐h urinary 18‐OHF were first established and quite important for its application in primary aldosteronism subtyping.

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18-Hydroxycorticosterone as a Marker for Primary Hyperaldosteronism

Cited by 6 publications

References 16 publications

Urinary excretion of 19-noraldosterone, 18, 19-dihydroxycorticosterone and 18-hydroxy-19-norcorticosterone in patients with aldosterone-producing adenoma or idiopathic hyperaldosteronism

Urinary excretion of 19-noraldosterone, 18, 19-dihydroxycorticosterone and 18-hydroxy-19-norcorticosterone in patients with aldosterone-producing adenoma or idiopathic hyperaldosteronism

Untersuchungen zum diagnostischen Stellenwert der Aldosteron-Vorstufe 18-Hydroxycorticosteron in der Diagnose und Differentialdiagnose des primären Hyperaldosteronismus

A dilute‐and‐shoot liquid chromatography–tandem mass spectrometry method for urinary 18‐hydroxycortisol quantification and its application in establishing reference intervals

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