Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome
Context: Autonomous cortisol secretion (ACS) has a relatively high prevalence in patients with primary aldosteronism (PA). There is still a lack of relevant studies to analyze the influence of ACS on diagnosing and managing PA. Objective: To evaluate the influence of ACS on image–adrenal venous sa...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-11-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/12/12/EC-23-0121.xml |
| _version_ | 1797450798627553280 |
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| author | Kuang Hung Bo-Ching Lee Po-Ting Chen Kao-Lang Liu Chin-Chen Chang Vin-Cent Wu Yen-Hung Lin |
| author_facet | Kuang Hung Bo-Ching Lee Po-Ting Chen Kao-Lang Liu Chin-Chen Chang Vin-Cent Wu Yen-Hung Lin |
| author_sort | Kuang Hung |
| collection | DOAJ |
| description | Context: Autonomous cortisol secretion (ACS) has a relatively high prevalence in patients with primary aldosteronism (PA). There is still a lack of relevant studies to analyze the influence of ACS on diagnosing and managing PA.
Objective: To evaluate the influence of ACS on image–adrenal venous sampling (AVS) correlation and the postoperative results.
Methods: This was a retrospective study using the Taiwan Primary Aldosteronism Investigation database from July 2017 to April 2020, with 327 PA patients enrolled. A total of 246 patients were included in the image–AVS analysis. Patients who had undergone unilateral adrenalectomy and a 12-month follow-up were included in the postoperative analysis.
Results: Sixty-five patients (26.4%) had ACS. The image–AVS discordance rate was higher in the ACS group compared to the non-ACS group (75.4% (n = 49) vs 56.4% (n = 102); odds ratio (OR) = 2.37 (CI: 1.26–4.48); P = 0.007). The complete biochemical success rate was higher in the non-ACS group than that in the ACS group (98.1% (n = 51) vs 64.3% (n = 9); OR = 28.333 (CI: 2.954–271.779); P = 0.001). In logistic regression analysis, ACS was the only factor associated with lower biochemical success (OR = 0.035 (CI: 0.004–0.339), P = 0.004).
Conclusion: PA patients with ACS have higher image–AVS discordance rate and worse biochemical outcomes after surgery. ACS was the only negative predictor of postoperative biochemical outcomes. Further studies and novel biomarkers for AVS are crucial for obtaining better postoperative outcomes in PA patients with ACS. |
| first_indexed | 2024-03-09T14:45:47Z |
| format | Article |
| id | doaj.art-c9282f1e4f6a49dc87968807d97814f4 |
| institution | Directory Open Access Journal |
| issn | 2049-3614 |
| language | English |
| last_indexed | 2024-03-09T14:45:47Z |
| publishDate | 2023-11-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-c9282f1e4f6a49dc87968807d97814f42023-11-27T07:09:02ZengBioscientificaEndocrine Connections2049-36142023-11-01121219https://doi.org/10.1530/EC-23-0121Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcomeKuang Hung0Bo-Ching Lee1Po-Ting Chen2Kao-Lang Liu3Chin-Chen Chang4Vin-Cent Wu5Yen-Hung Lin6Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanContext: Autonomous cortisol secretion (ACS) has a relatively high prevalence in patients with primary aldosteronism (PA). There is still a lack of relevant studies to analyze the influence of ACS on diagnosing and managing PA. Objective: To evaluate the influence of ACS on image–adrenal venous sampling (AVS) correlation and the postoperative results. Methods: This was a retrospective study using the Taiwan Primary Aldosteronism Investigation database from July 2017 to April 2020, with 327 PA patients enrolled. A total of 246 patients were included in the image–AVS analysis. Patients who had undergone unilateral adrenalectomy and a 12-month follow-up were included in the postoperative analysis. Results: Sixty-five patients (26.4%) had ACS. The image–AVS discordance rate was higher in the ACS group compared to the non-ACS group (75.4% (n = 49) vs 56.4% (n = 102); odds ratio (OR) = 2.37 (CI: 1.26–4.48); P = 0.007). The complete biochemical success rate was higher in the non-ACS group than that in the ACS group (98.1% (n = 51) vs 64.3% (n = 9); OR = 28.333 (CI: 2.954–271.779); P = 0.001). In logistic regression analysis, ACS was the only factor associated with lower biochemical success (OR = 0.035 (CI: 0.004–0.339), P = 0.004). Conclusion: PA patients with ACS have higher image–AVS discordance rate and worse biochemical outcomes after surgery. ACS was the only negative predictor of postoperative biochemical outcomes. Further studies and novel biomarkers for AVS are crucial for obtaining better postoperative outcomes in PA patients with ACS.https://ec.bioscientifica.com/view/journals/ec/12/12/EC-23-0121.xmlhyperaldosteronismautonomous cortisol secretioncomputed tomographyadrenalectomy |
| spellingShingle | Kuang Hung Bo-Ching Lee Po-Ting Chen Kao-Lang Liu Chin-Chen Chang Vin-Cent Wu Yen-Hung Lin Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome Endocrine Connections hyperaldosteronism autonomous cortisol secretion computed tomography adrenalectomy |
| title | Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome |
| title_full | Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome |
| title_fullStr | Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome |
| title_full_unstemmed | Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome |
| title_short | Influence of autonomous cortisol secretion in patients with primary aldosteronism: subtype analysis and postoperative outcome |
| title_sort | influence of autonomous cortisol secretion in patients with primary aldosteronism subtype analysis and postoperative outcome |
| topic | hyperaldosteronism autonomous cortisol secretion computed tomography adrenalectomy |
| url | https://ec.bioscientifica.com/view/journals/ec/12/12/EC-23-0121.xml |
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