Dissociation in the Excretion of Different Aldosterone Metabolites and Unmetabolized (‘Free’) Aldosterone in Hypertension

Abdelhamid, S.; Vecsei, P.; Haack, D.; Gless, K.-H.; Walb, Dieter; Lichtwald, K.; Fiegel, P.

doi:10.1042/cs0570409

Cited by 14 publications

(5 citation statements)

References 9 publications

(6 reference statements)

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“…The sum of conjugated and free tetrahydroaldosterone and 21-deoxytetrahy droaldosterone was the best discriminator for the patients with primary aldosteronism. The diagnostic shortcomings of the urine aldoste rone-18-glucuronide value have also pre viously been reported [10][11][12],…”

Section: Discussionmentioning

confidence: 99%

21-Deoxytetrahydroaldosterone Excretion in Primary Hyperaldosteronism

et al. 1985

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In earlier studies by our group it was shown that the urinary tetrahydroaldosterone excretion is a more reliable test for the diagnosis of primary aldosteronism than aldosterone-18-glucuronide (‘urinary aldosterone’). However, in several patients with primary aldosteronism even the tetrahydroaldosterone values remained in the normal range. As the possible cause for this observation, the role of intestinal bacteria was considered which may transform tetrahydroaldosterone into 21-deoxytetrahydroaldosterone. Using a 21-deoxytetrahydroaldosterone radioimmunoassay, this hypothesis could be confirmed. The sums of the urinary 21-deoxytetrahydroaldosterone and tetahydroaldosterone excretions revealed to be of better diagnostic value than the tetrahydroaldosterone values alone.

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Section: Discussionmentioning

confidence: 99%

21-Deoxytetrahydroaldosterone Excretion in Primary Hyperaldosteronism

et al. 1985

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“…It is primarily a liver metabolite, corresponding to around half of the aldosterone metabolites [67,87]. Measuring tetrahydroaldosterone in the urine involves hydrolysis of the glucuronide conjugate with a beta-glucuronidase and measurement by several methods, including radioimmunoassay, highperformance liquid chromatography (HPLC)-MS-MS [88][89][90][91][92][93]. Since most aldosterone is metabolized to 3α,5β-tetrahydroaldosterone, it has been proposed that it is a better indicator of aldosterone secretion; however, the metabolism of aldosterone to the 3α,5βtetrahydroaldosterone is affected by different disease states; in particular, it is decreased in congestive heart failure and cirrhosis of the liver [94,95].…”

Section: Tetrahydroaldosteronementioning

confidence: 99%

An Abbreviated History of Aldosterone Metabolism, Current and Future Challenges

Gómez-Sánchez

2023

Exp Clin Endocrinol Diabetes

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The initial isolation of adrenal steroids from large quantities of animal adrenals resulted in an amorphous fraction resistant to crystallization and identification that had potent effects on electrolyte transport. Aldosterone was eventually isolated and identified in the fraction and was soon shown to cause hypertension when in excess. The autonomous and excessive production of aldosterone, primary aldosteronism, is the most common cause of secondary hypertension. Aldosterone is metabolized in the liver and kidney and its metabolites conjugated with glucuronic acid for excretion. The most common liver metabolite is 3,5-tetrahydroaldosterone-3-glucuronide; that of the kidney is aldosterone-18-oxo-glucuronide. Their values, especially the aldosterone-18-oxo-glucuronide, are commonly used for the diagnosis of primary aldosteronism because they provide and integrated value of the total daily production of aldosterone. Conversion of aldosterone to 18-oxo-glucuronide is impeded by drugs, like some common NSAIDS that compete for UGT2B7, the most important glucuronosyltransferase for aldosterone metabolism. Tetrahydroaldosterone is the most abundant metabolite and most reliable for the diagnosis of primary aldosteronism, but is not commonly measured.

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“…Das ist verständlich, denn bei den meisten Hyperplasie-Patienten werden im Referenzbereich liegende Werte vorgefunden. gen wurden auch von anderen Autoren (7) gemacht und bestätigen frühere eigene Untersuchungen (5,6). Bei einem großen Anteil dieser Patienten war 18-OH-Corticosteron erhöht, insbesondere in der Adenom-Gruppe.…”

Section: Abgrenzung Des Primären Hyperaldosteronismus Von Der Essentiunclassified

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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Dissociation in the Excretion of Different Aldosterone Metabolites and Unmetabolized (‘Free’) Aldosterone in Hypertension

Cited by 14 publications

References 9 publications

21-Deoxytetrahydroaldosterone Excretion in Primary Hyperaldosteronism

21-Deoxytetrahydroaldosterone Excretion in Primary Hyperaldosteronism

An Abbreviated History of Aldosterone Metabolism, Current and Future Challenges

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

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