open access

Vol 71, No 1 (2020)
Original Paper
Published online: 2019-11-04
Submitted: 2019-08-25
Accepted: 2019-10-23
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The aldosterone index could be used to diagnose the dominant gland in primary aldosteronism — a retrospective study

Shen-Zhuo Liu, Liang Zhou, Tao Chen, Zhi-Hong Liu, Zheng-Ju Ren, Yu-Chun Zhu
DOI: 10.5603/EP.a2019.0054
·
Pubmed: 31681973
·
Endokrynologia Polska 2020;71(1):42-50.

open access

Vol 71, No 1 (2020)
Original Paper
Published online: 2019-11-04
Submitted: 2019-08-25
Accepted: 2019-10-23

Abstract

Introduction: Failed cannulation in the right adrenal vein, which makes the sampling results in the contralateral vein and inferior vena cava (IVC) nonsense, is the main obstacle of using adrenal vein sampling (AVS) in the lateralisation diagnosis in primary aldosteronism (PA). We performed a retrospective study to evaluate the specificity and sensitivity of using the aldosterone index (AI) in PA lateralisation diagnosis.

Material and methods: We enrolled 116 patients who were diagnosed with PA and then underwent AVS in the West China Hospital of Sichuan University from April 2015 to April 2017. The AI, calculated by dividing the aldosterone concentration of the failed side by the aldosterone concentration of IVC, was used for lateralisation diagnosis if the cannulation was judged to be failed by traditional method. Patients with dominant adrenal gland based on successful AVS were included in subgroup 2 (n = 75), while the patients diagnosed with a dominant gland using AI method were enrolled in subgroup 1 (n = 41).

Results: No significant difference of clinical and biochemical findings between the two groups was detected (p value after operation > 0.05). ROC analysis was performed to test the specificity and sensitivity based on the AI in subgroup 2. The AUC for dominant gland detection was 0.76, which resulted in 91.3% sensitivity and 67.53% specificity. The positive and negative likelihood ratios were 2.81.

Conclusions: Our data suggested that the modified strategy using AI to diagnose the dominant gland in PA is an efficient method when cannulation has failed in the right side.

Abstract

Introduction: Failed cannulation in the right adrenal vein, which makes the sampling results in the contralateral vein and inferior vena cava (IVC) nonsense, is the main obstacle of using adrenal vein sampling (AVS) in the lateralisation diagnosis in primary aldosteronism (PA). We performed a retrospective study to evaluate the specificity and sensitivity of using the aldosterone index (AI) in PA lateralisation diagnosis.

Material and methods: We enrolled 116 patients who were diagnosed with PA and then underwent AVS in the West China Hospital of Sichuan University from April 2015 to April 2017. The AI, calculated by dividing the aldosterone concentration of the failed side by the aldosterone concentration of IVC, was used for lateralisation diagnosis if the cannulation was judged to be failed by traditional method. Patients with dominant adrenal gland based on successful AVS were included in subgroup 2 (n = 75), while the patients diagnosed with a dominant gland using AI method were enrolled in subgroup 1 (n = 41).

Results: No significant difference of clinical and biochemical findings between the two groups was detected (p value after operation > 0.05). ROC analysis was performed to test the specificity and sensitivity based on the AI in subgroup 2. The AUC for dominant gland detection was 0.76, which resulted in 91.3% sensitivity and 67.53% specificity. The positive and negative likelihood ratios were 2.81.

Conclusions: Our data suggested that the modified strategy using AI to diagnose the dominant gland in PA is an efficient method when cannulation has failed in the right side.

Get Citation

Keywords

primary aldosteronism; aldosterone-producing adenoma; adrenal vein sampling

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About this article
Title

The aldosterone index could be used to diagnose the dominant gland in primary aldosteronism — a retrospective study

Journal

Endokrynologia Polska

Issue

Vol 71, No 1 (2020)

Pages

42-50

Published online

2019-11-04

DOI

10.5603/EP.a2019.0054

Pubmed

31681973

Bibliographic record

Endokrynologia Polska 2020;71(1):42-50.

Keywords

primary aldosteronism
aldosterone-producing adenoma
adrenal vein sampling

Authors

Shen-Zhuo Liu
Liang Zhou
Tao Chen
Zhi-Hong Liu
Zheng-Ju Ren
Yu-Chun Zhu

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