Impact of the Cosecretion of Cortisol on Surgical Outcomes and in the Urinary Steroid Profile in Primary Aldosteronism
Authors' conclusion
Patients with MACS-PA exhibited a higher excretion of glucocorticoid metabolites and a lower response to ACTH than patients with PA without associated MACS. Patients with MACS-PA experience a lower quantitative improvement in systolic and diastolic blood pressure after adrenalectomy than patients with only PA.
Study context
- Population
- Patients consecutively diagnosed with PA, with 24-hour urinary steroid profile (33 metabolites) before and after 250 μg IV cosyntropin
- Participants
- 53 participants
- Exposure
- PA with MACS vs PA without MACS
- MACS-PAn = 15
- Only PAn = 38reference
- Outcome
- Urinary steroid profile and surgical outcomes
Methodological detailsmulticentre, consecutive patients
- Multicentre
- Consecutive patients
Main finding
As reported in the abstract
- Baseline: higher β-cortol and β-cortolone with MACS-PA vs only PA
- After adrenocorticotropic hormone (ACTH) stimulation: lower increase of glucocorticoid excretion with MACS-PA, including α-cortol and 11β-OH-androsterone
- Some metabolites decreased after ACTH stimulation (tetrahydrocortisone, α-cortolone, β-cortolone)
- Lower postsurgical decrease in systolic and diastolic BP with MACS-PA vs only PA
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Baseline characteristics | P = 0.034 |
- Baseline characteristics: higher A1C levels with MACS-PA; other characteristics similar
Original publication
Impact of the Cosecretion of Cortisol on Surgical Outcomes and in the Urinary Steroid Profile in Primary Aldosteronism. Endocr Pract. Published 26 May 2026. doi:10.
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