Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
- PDF / 775,051 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 80 Downloads / 165 Views
RESEARCH ARTICLE
Open Access
Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports Tomoko Yamada1, Hidenori Fukuoka1* , Yusei Hosokawa1, Yukiko Odake2, Kenichi Yoshida2, Ryusaku Matsumoto2, Hironori Bando1, Yuko Okada1, Yushi Hirota1, Genzo Iguchi1, Wataru Ogawa2 and Yutaka Takahashi2
Abstract Background: Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA). Methods: In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n = 18), SCS (n = 18), and NFA (n = 31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled. Results: PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3 ~ 2.8) vs. 0.7 (0.5 ~ 1.8) and 0.9 (0.6 ~ 1.4) ng/mL/h; p = 0.018 and p = 0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5 ~ 79.5) vs. 156.0 (92.9 ~ 194.5) and 114.9 (90.1 ~ 153.4); p = 0.001 and p < 0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA > 1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR < 95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA. Conclusions: ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registration: This study was not registered because of the retrospective analysis. Keywords: Pheochromocytoma, Adrenal incidentaloma, Renin, Aldosterone, ARR
Background Pheochromocytoma (PCC) is a tumor arising from adrenomedullary chromaffin cells that commonly secret catecholamines (CAs), namely, adrenaline (Ad), noradrenaline (NA), and dopamine (DA). CAs can stimulate all major adrenergic receptors, including α1, α2, β1, and β2 receptors. Activation of α1 adrenergic receptors, located in vascular walls, induces * Correspondence: [email protected] 1 Division of Diabetes and Endocrinology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan Full list of author information is available at the end of the article
significant vasoconstriction, which chronically causes hypovolemia. Patients with PCC require surgical treatment to prevent fatal changes in hemodynamics [1]. Since life-threating problems, such as hypovolemic shock, can occur during the perioperative period, α1 blocker with salt loading shou
Data Loading...
