Steroidomics-Based Screening for Primary Aldosteronism: Impact of antihypertensive Drugs

醛固酮 原发性醛固酮增多症 医学 盐皮质激素 内科学 内分泌学 肾素-血管紧张素系统 盐皮质激素受体 醛固酮增多症 血浆肾素活性 醛固酮合酶 血压
作者
Georgiana Constantinescu,Sven Gruber,Sybille Fuld,Mirko Peitzsch,Manuel Schulze,Hanna Remde,Lydia Kürzinger,Jun Yang,Tina Yen,Tracy Ann Williams,Lisa Müller,Martín Reincke,Jacques W.M. Lenders,Felix Beuschlein,Christina Pamporaki,Graeme Eisenhofer
出处
期刊:Hypertension [Ovid Technologies (Wolters Kluwer)]
标识
DOI:10.1161/hypertensionaha.124.23029
摘要

BACKGROUND: Diagnosis of primary aldosteronism (PA) is complicated by the need to withdraw antihypertensive medications that interfere with test results, particularly renin. This study examined whether machine learning-based steroid-probability scores offer a renin measurement-independent approach for testing less prone to interference than the aldosterone-to-renin ratio (ARR). METHODS: This prospective multicenter cohort study involved the use of plasma steroidomics and the ARR in 839 patients tested for PA, including 190 with and 578 without PA (71 indeterminate). Receiver operating characteristic curves for steroid-probability scores and the ARR were examined with and without interfering medications. Impacts of individual medications on plasma aldosterone, 18-oxocortisol, 18-hydroxycortisol, steroid-probability scores, renin, and ARRs were examined by multivariable and paired analyses in patients with and without PA. RESULTS: Receiver operating characteristic curves indicated a significant impact of interfering antihypertensive medications on the diagnostic performance of the ARR and minimal impact on steroid-probability scores. Mineralocorticoid receptor antagonists increased plasma aldosterone, 18-oxocortisol, and 18-hydroxycortisol in patients without PA and resulted in false-positive test results for steroid-probability scores and false-negative results for the ARR. Diuretics increased aldosterone, 18-oxocortisol, and steroid-probability scores in patients without PA, whereas angiotensin-converting enzyme inhibitors decreased aldosterone, steroid-probability scores, and ARRs. Beta-adrenoceptor blockers, dihydropyridine calcium channel blockers, and angiotensin receptor blockers had negligible impact on mineralocorticoids and steroid-probability scores. CONCLUSIONS: Among antihypertensive drugs that impact plasma aldosterone, 18-oxocortisol, and 18-hydroxycortisol, mineralocorticoid receptor antagonists stood out as a cause of false-positive results for derived steroid-probability scores. Other antihypertensives have minimal or no impact, an advantage for use of steroid-probability scores over the ARR when those medications cannot be withdrawn. REGISTRATION: URL: https://drks.de/ ; Unique identifier: DRKS00017084.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
lily8675完成签到,获得积分10
刚刚
刚刚
刚刚
1秒前
1秒前
1秒前
权千万发布了新的文献求助10
2秒前
小何发布了新的文献求助10
3秒前
3秒前
4秒前
hdh016发布了新的文献求助10
4秒前
小飞完成签到,获得积分10
4秒前
聪明小于完成签到,获得积分10
4秒前
4秒前
Tarahu完成签到,获得积分10
5秒前
周周完成签到,获得积分10
5秒前
咳欧克发布了新的文献求助10
5秒前
螺蛳粉完成签到,获得积分10
6秒前
zy_发布了新的文献求助30
6秒前
6秒前
22222发布了新的文献求助20
6秒前
小飞发布了新的文献求助10
7秒前
timber乾杯发布了新的文献求助10
7秒前
糊涂生活糊涂过完成签到 ,获得积分10
8秒前
烤鸭发布了新的文献求助10
9秒前
oceanao应助灯灯采纳,获得10
10秒前
丘比特应助故意的怜晴采纳,获得10
10秒前
Rhino完成签到 ,获得积分10
11秒前
LonelyCMA完成签到 ,获得积分10
11秒前
辛勤夜安发布了新的文献求助10
12秒前
13秒前
掉头发的小白完成签到,获得积分10
13秒前
Jing完成签到 ,获得积分20
15秒前
ZXneuro完成签到,获得积分10
15秒前
CipherSage应助YC采纳,获得10
15秒前
sunshine完成签到,获得积分10
15秒前
无花果应助包容店员采纳,获得10
16秒前
小小王科研完成签到,获得积分10
16秒前
17秒前
tca2204完成签到,获得积分10
17秒前
高分求助中
Evolution 10000
Becoming: An Introduction to Jung's Concept of Individuation 600
Distribution Dependent Stochastic Differential Equations 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
A new species of Velataspis (Hemiptera Coccoidea Diaspididae) from tea in Assam 500
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 500
The Kinetic Nitration and Basicity of 1,2,4-Triazol-5-ones 440
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3159243
求助须知:如何正确求助?哪些是违规求助? 2810372
关于积分的说明 7887509
捐赠科研通 2469200
什么是DOI,文献DOI怎么找? 1314702
科研通“疑难数据库(出版商)”最低求助积分说明 630697
版权声明 602012