18-oxocortisol measurement in adrenal vein sampling as a biomarker for subclassifying primary aldosteronism

  • J Clin Endocrinol Metab. 2011 Aug;96(8):E1272-8. doi: 10.1210/jc.2010-2785.
Yasuhiro Nakamura  1 ,  Fumitoshi Satoh ,  Ryo Morimoto ,  Masataka Kudo ,  Kei Takase ,  Celso E Gomez-Sanchez ,  Seijiro Honma ,  Mitsunobu Okuyama ,  Kouwa Yamashita ,  William E Rainey ,  Hironobu Sasano ,  Sadayoshi Ito
Affiliations
  • 1. Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai 980-8574, Japan.
PMID: 21593107 DOI: 10.1210/jc.2010-2785
Abstract

Context: 18-Oxocortisol (18-oxoF) is a derivative of cortisol (F) that is produced by aldosterone synthase (CYP11B2). The potential for this steroid as a biomarker for differentiating patients with aldosterone-producing adenoma (APA) from those with idiopathic hyperaldosteronism (IHA) has not been examined.

Objectives: We measured 18-oxoF, aldosterone, and F in plasma from adrenal vein sampling (AVS) of patients with primary aldosteronism. We compared 18-oxoF levels and 18-oxoF/F ratios for their potential to differentiate APA from IHA.

Design, setting, and subjects: This study measured 18-oxoF, F, and aldosterone in AVS obtained from patients with unilateral APA (14 cases) or bilateral IHA (seven cases, 14 samples total) using liquid chromatography-tandem mass spectrometry and RIA analyses.

Results: The levels of 18-oxoF and the ratios of 18-oxoF/F, before and after ACTH stimulation, were significantly higher in blood-draining APA than in those from the contralateral adrenal glands and from adrenal glands with IHA.

Conclusions: The 18-oxoF levels and ratios of 18-oxoF/F in AVS samples can be a clinically useful biomarker for differentiating APA from IHA and for determining the localization or lateralization of APA in patients with primary aldosteronism.

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