Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study
Abstract Background The diagnosis of primary aldosteronism (PA) requires screening and confirmation testing. The present study examined whether the 1 µg ACTH stimulation test for plasma aldosterone concentration (PAC) can accurately diagnose PA by bypassing the regular confirmatory steps of PA diagn...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12902-024-01563-y |
| _version_ | 1797259229935960064 |
|---|---|
| author | Worapaka Manosroi Pichitchai Atthakomol Piti Inthaphan Supornthip Hintong |
| author_facet | Worapaka Manosroi Pichitchai Atthakomol Piti Inthaphan Supornthip Hintong |
| author_sort | Worapaka Manosroi |
| collection | DOAJ |
| description | Abstract Background The diagnosis of primary aldosteronism (PA) requires screening and confirmation testing. The present study examined whether the 1 µg ACTH stimulation test for plasma aldosterone concentration (PAC) can accurately diagnose PA by bypassing the regular confirmatory steps of PA diagnosis. Methods A cross-sectional study with a total of 36 patients with an aldosterone-renin ratio (ARR) > 20 ng/dL per ng/m/hr were included. The confirmation test for PA was performed by saline infusion and the patients were categorized into PA and non-PA. PAC was collected at 20 and 40 min after 1 µg ACTH stimulation test. Multivariable logistic regression analysis was performed, and the associations are presented as odds ratios (OR) and 95% confidence intervals (CI). Diagnostic accuracy is presented as AuROC. Results Multivariable analysis found only PAC at 20 min after ACTH stimulation showed significant association with a diagnosis of PA (OR 1.18, 95%CI (0.99, 1.31), p = 0.040). AuROC for this value was 0.95 and the proposed cut-off was 52 ng/dL with a sensitivity of 71.4% and a specificity of 96.6%. Conclusions Diagnosing PA may be aided by PAC at 20 min following 1 µg ACTH stimulation. This value may be used with patients for whom the confirmation test for PA cannot be conducted. |
| first_indexed | 2024-04-24T23:06:07Z |
| format | Article |
| id | doaj.art-96a730ef4ba943c4ba454c94b28e8900 |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-04-24T23:06:07Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-96a730ef4ba943c4ba454c94b28e89002024-03-17T12:28:49ZengBMCBMC Endocrine Disorders1472-68232024-03-012411710.1186/s12902-024-01563-yPlasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional studyWorapaka Manosroi0Pichitchai Atthakomol1Piti Inthaphan2Supornthip Hintong3Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityClinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai UniversityDepartment of Internal Medicine, Nakornping HospitalDivision of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityAbstract Background The diagnosis of primary aldosteronism (PA) requires screening and confirmation testing. The present study examined whether the 1 µg ACTH stimulation test for plasma aldosterone concentration (PAC) can accurately diagnose PA by bypassing the regular confirmatory steps of PA diagnosis. Methods A cross-sectional study with a total of 36 patients with an aldosterone-renin ratio (ARR) > 20 ng/dL per ng/m/hr were included. The confirmation test for PA was performed by saline infusion and the patients were categorized into PA and non-PA. PAC was collected at 20 and 40 min after 1 µg ACTH stimulation test. Multivariable logistic regression analysis was performed, and the associations are presented as odds ratios (OR) and 95% confidence intervals (CI). Diagnostic accuracy is presented as AuROC. Results Multivariable analysis found only PAC at 20 min after ACTH stimulation showed significant association with a diagnosis of PA (OR 1.18, 95%CI (0.99, 1.31), p = 0.040). AuROC for this value was 0.95 and the proposed cut-off was 52 ng/dL with a sensitivity of 71.4% and a specificity of 96.6%. Conclusions Diagnosing PA may be aided by PAC at 20 min following 1 µg ACTH stimulation. This value may be used with patients for whom the confirmation test for PA cannot be conducted.https://doi.org/10.1186/s12902-024-01563-yPrimary aldosteronismACTH stimulation testSerum aldosteroneSerum cortisol |
| spellingShingle | Worapaka Manosroi Pichitchai Atthakomol Piti Inthaphan Supornthip Hintong Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study BMC Endocrine Disorders Primary aldosteronism ACTH stimulation test Serum aldosterone Serum cortisol |
| title | Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study |
| title_full | Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study |
| title_fullStr | Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study |
| title_full_unstemmed | Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study |
| title_short | Plasma aldosterone response to ACTH stimulation test for diagnosis of primary aldosteronism: a cross-sectional study |
| title_sort | plasma aldosterone response to acth stimulation test for diagnosis of primary aldosteronism a cross sectional study |
| topic | Primary aldosteronism ACTH stimulation test Serum aldosterone Serum cortisol |
| url | https://doi.org/10.1186/s12902-024-01563-y |
| work_keys_str_mv | AT worapakamanosroi plasmaaldosteroneresponsetoacthstimulationtestfordiagnosisofprimaryaldosteronismacrosssectionalstudy AT pichitchaiatthakomol plasmaaldosteroneresponsetoacthstimulationtestfordiagnosisofprimaryaldosteronismacrosssectionalstudy AT pitiinthaphan plasmaaldosteroneresponsetoacthstimulationtestfordiagnosisofprimaryaldosteronismacrosssectionalstudy AT supornthiphintong plasmaaldosteroneresponsetoacthstimulationtestfordiagnosisofprimaryaldosteronismacrosssectionalstudy |