Apparent Bilateral Aldosterone Suppression During Adrenal Vein Sampling: An Artefact of the Liaison Chemiluminescence Immunoassay and Other Causes Revealed by Comparisons With Another Commercial Immunoassay and Mass Spectrometry
Authors' conclusion
ABAS is a relatively common artefact of the Liaison immunoassay of aldosterone. More rarely, ABAS may reflect sampling blood from an adrenal venous tributary that does not drain from the site of excess aldosterone secretion.
Study context
- Population
- Patients with primary aldosteronism who underwent bilaterally selective non-stimulated adrenal vein sampling (AVS)
- Participants
- 216 patients
- Exposure
- Aldosterone by Liaison and iSYS immunoassays vs LC-MS/MS
- LC-MS/MSn = 216reference
- Liaisonn = 110
- iSYSn = 106
- Outcome
- Apparent bilateral aldosterone suppression (ABAS): aldosterone-to-cortisol ratio below 1.0 in adrenal vs peripheral vein samples, bilaterally
Methodological detailsmethod comparison, bilaterally selective non-stimulated AVS
- Method comparison
- Bilaterally selective non-stimulated AVS
Main finding
As reported in the abstract
ABAS rate
P = 0.0004
Observational data: associations, not effects.
Further findings
| Outcome | LC-MS/MS | Liaison | iSYS | P value |
|---|---|---|---|---|
| ABAS rate, Liaison samplingsLiaison vs LC-MS/MS | 0.9% | 14.5% | — not stated in the abstract | P < 0.0001 |
| ABAS rate, Liaison with LC-MS/MS-measured cortisol substitutedLiaison vs LC-MS/MS | 0.9% | 10.9% | — not stated in the abstract | P = 0.0007 |
| ABAS rate, iSYS samplingsiSYS vs Liaison · iSYS rate a third that of Liaison | 5.7% | — not stated in the abstract | 4.7% | P = 0.0202 |
— not stated in the abstract
Apparent bilateral aldosterone suppression (ABAS) rate, iSYS samplings
- iSYS ABAS rate did not differ from LC-MS/MS
ABAS confined to LC-MS/MS
- In one patient resolved by a second sampling revealing pronounced aldosterone secretion vs earlier suppression
- 1 patient
Original publication
Apparent Bilateral Aldosterone Suppression During Adrenal Vein Sampling: An Artefact of the Liaison Chemiluminescence Immunoassay and Other Causes Revealed by Comparisons With Another Commercial Immunoassay and Mass Spectrometry. Clin Endocrinol (Oxf). Published 29 March 2026. doi:10.
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