Prevalence of Cortisol Cosecretion in Patients With Primary Aldosteronism: Role of Metanephrine in Adrenal Vein Sampling
Authors' conclusion
The assessment of metanephrine levels in AVS is useful for the determination of selectivity and lateralization, allowing an accurate diagnosis, especially in patients with asymmetrical cortisol secretion.
Study context
- Population
- Patients with PA who underwent adrenal venous sampling (AVS)88 bilateral successful AVS
- Participants
- 101 patients
- Exposure
- A/M lateralization index (LI) vs A/C LI for PA subtype diagnosis in AVS
- Unstimulated AVSn = 49
- Unstimulated and cosyntropin-stimulated AVSn = 52
- Outcome
- Prevalence of asymmetrical cortisol secretion, assessed by C/M LI
Main finding
As reported in the abstract
Asymmetrical cortisol secretion
Prevalence of asymmetrical cortisol secretion in PA
18%
Observational data: associations, not effects.
Further findings
Discordant subtype diagnosis, A/M LI vs A/C LI
- Discordant diagnosis
- 14%
- Unilateral PA with A/M LI instead of bilateral PA with A/C LI
- 9%
- Bilateral PA with A/M LI instead of unilateral PA
- 5%
Original publication
Prevalence of Cortisol Cosecretion in Patients With Primary Aldosteronism: Role of Metanephrine in Adrenal Vein Sampling. J Clin Endocrinol Metab. Published 28 March 2023. doi:10.
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