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Article: A clinical prediction score using age at diagnosis and saline infusion test parameters can predict aldosterone-producing adenoma from idiopathic adrenal hyperplasia

TitleA clinical prediction score using age at diagnosis and saline infusion test parameters can predict aldosterone-producing adenoma from idiopathic adrenal hyperplasia
Authors
KeywordsAdrenal adenoma
Adrenal hyperplasia
Clinical prediction
Primary aldosteronism
Saline infusion test
Issue Date2020
PublisherSpringer. The Journal's web site is located at https://link.springer.com/journal/40618
Citation
Journal of Endocrinological Investigation, 2020, v. 43 n. 3, p. 347-355 How to Cite?
AbstractPurpose: Accurate subtyping of the primary aldosteronism into aldosterone-producing adenoma (APA) and idiopathic adrenal hyperplasia (IAH) is important to direct for specific treatment modalities. The objective of the study was to compare the clinical and biochemical parameters of APA and IAH patients to derive a Clinical Prediction Score reliably predicting APA from IAH. Methods: This was a retrospective multi-centre study recruiting 38 APA patients and 42 IAH patients from four major hospitals in Hong Kong using database from Surgical Outcomes Monitoring and Improvement Programme and Clinical Data Analysis and Reporting System. Their clinical and biochemical parameters were evaluated. Results: Patients in APA group were younger than IAH group (mean age 48.6 ± 9.2 vs. 57.1 ± 7.3 years old, p < 0.001), had more suppressed renin before saline infusion in saline infusion test (SIT) (median 0.19 [IQR 0.15–0.37] vs. 0.39 [IQR 0.19–0.69] ng/mL/h, p = 0.01), and higher aldosterone level after saline infusion in SIT (median 674 [IQR 498–1000] vs. 327 [IQR 242–483] pmol/L, p < 0.001). A clinical prediction score using three parameters was devised, comprising age at diagnosis < 50 years, PRA before saline infusion in SIT ≤ 0.26 ng/mL/h, and aldosterone level after saline infusion in SIT ≥ 424 pmol/L. A score of 2 would predict APA with a sensitivity of 84.2% and specificity of 88.1%, and a score of 3 would predict APA with a sensitivity of 31.6% and specificity of 100%. Conclusions: Clinical Prediction Score based on the combination of age at diagnosis, PRA, and aldosterone level in the saline infusion tests could reliably predict APA from IAH. © 2019, Italian Society of Endocrinology (SIE).
Persistent Identifierhttp://hdl.handle.net/10722/290935
ISSN
2023 Impact Factor: 3.9
2023 SCImago Journal Rankings: 1.067
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, HT-
dc.contributor.authorWoo, YC-
dc.contributor.authorFong, CHY-
dc.contributor.authorTan, KCB-
dc.contributor.authorLau, EYF-
dc.contributor.authorChan, KW-
dc.contributor.authorLeung, JYY-
dc.date.accessioned2020-11-02T05:49:11Z-
dc.date.available2020-11-02T05:49:11Z-
dc.date.issued2020-
dc.identifier.citationJournal of Endocrinological Investigation, 2020, v. 43 n. 3, p. 347-355-
dc.identifier.issn0391-4097-
dc.identifier.urihttp://hdl.handle.net/10722/290935-
dc.description.abstractPurpose: Accurate subtyping of the primary aldosteronism into aldosterone-producing adenoma (APA) and idiopathic adrenal hyperplasia (IAH) is important to direct for specific treatment modalities. The objective of the study was to compare the clinical and biochemical parameters of APA and IAH patients to derive a Clinical Prediction Score reliably predicting APA from IAH. Methods: This was a retrospective multi-centre study recruiting 38 APA patients and 42 IAH patients from four major hospitals in Hong Kong using database from Surgical Outcomes Monitoring and Improvement Programme and Clinical Data Analysis and Reporting System. Their clinical and biochemical parameters were evaluated. Results: Patients in APA group were younger than IAH group (mean age 48.6 ± 9.2 vs. 57.1 ± 7.3 years old, p < 0.001), had more suppressed renin before saline infusion in saline infusion test (SIT) (median 0.19 [IQR 0.15–0.37] vs. 0.39 [IQR 0.19–0.69] ng/mL/h, p = 0.01), and higher aldosterone level after saline infusion in SIT (median 674 [IQR 498–1000] vs. 327 [IQR 242–483] pmol/L, p < 0.001). A clinical prediction score using three parameters was devised, comprising age at diagnosis < 50 years, PRA before saline infusion in SIT ≤ 0.26 ng/mL/h, and aldosterone level after saline infusion in SIT ≥ 424 pmol/L. A score of 2 would predict APA with a sensitivity of 84.2% and specificity of 88.1%, and a score of 3 would predict APA with a sensitivity of 31.6% and specificity of 100%. Conclusions: Clinical Prediction Score based on the combination of age at diagnosis, PRA, and aldosterone level in the saline infusion tests could reliably predict APA from IAH. © 2019, Italian Society of Endocrinology (SIE).-
dc.languageeng-
dc.publisherSpringer. The Journal's web site is located at https://link.springer.com/journal/40618-
dc.relation.ispartofJournal of Endocrinological Investigation-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI]-
dc.subjectAdrenal adenoma-
dc.subjectAdrenal hyperplasia-
dc.subjectClinical prediction-
dc.subjectPrimary aldosteronism-
dc.subjectSaline infusion test-
dc.titleA clinical prediction score using age at diagnosis and saline infusion test parameters can predict aldosterone-producing adenoma from idiopathic adrenal hyperplasia-
dc.typeArticle-
dc.identifier.emailFong, CHY: kalofong@hku.hk-
dc.identifier.emailTan, KCB: kcbtan@hkucc.hku.hk-
dc.identifier.emailLau, EYF: lauyfe@hku.hk-
dc.identifier.emailChan, KW: chriskwc@hku.hk-
dc.identifier.emailLeung, JYY: leungyyj@hku.hk-
dc.identifier.authorityTan, KCB=rp00402-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s40618-019-01114-6-
dc.identifier.pmid31529391-
dc.identifier.scopuseid_2-s2.0-85073822680-
dc.identifier.hkuros318197-
dc.identifier.volume43-
dc.identifier.issue3-
dc.identifier.spage347-
dc.identifier.epage355-
dc.identifier.isiWOS:000512798600009-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0391-4097-

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