scholarly journals Latent Autonomous Cortisol Secretion From Apparently Nonfunctioning Adrenal Tumor in Nonlateralized Hyperaldosteronism

2019 ◽  
Vol 104 (10) ◽  
pp. 4382-4389 ◽  
Author(s):  
Youichi Ohno ◽  
Masakatsu Sone ◽  
Nobuya Inagaki ◽  
Yoshiyu Takeda ◽  
Isao Kurihara ◽  
...  
Keyword(s):  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Adrenal Tumors ◽  
Cortisol Secretion ◽  
Hormone Levels ◽  
Clinical Complications ◽  
Basal Cortisol ◽  
Autonomous Cortisol Secretion ◽  
Cortisol Levels

Abstract Context Adrenal tumors (ATs), even those diagnosed as nonfunctioning, may cause metabolic disorders. Some primary aldosteronism (PA) patients with ATs are diagnosed with bilateral PA based on adrenal venous sampling (AVS), and their ATs are apparently nonfunctioning. Objective To clarify the influence of apparently nonfunctioning ATs, we compared hormone levels and clinical complications between bilateral PA cases with and without ATs. Design, setting, and participants After retrospectively assessing 2814 patients with PA in the multicenter Japan PA study, bilateral PA cases on AVS were divided into cases with and without ATs by computed tomography findings. Importantly, patients with cortisol levels >1.8 µg/dL after the 1-mg dexamethasone suppression test (DST) were excluded. Clinical characteristics and biochemical data were compared between them. The correlation between AT size and hormone levels was also analyzed. Main outcome measures Analyzed were 196 bilateral PA patients with ATs and 331 those without ATs. Although basal cortisol and aldosterone levels were similar between them, cortisol levels after the 1-mg DST and the prevalences of diabetes mellitus and proteinuria were significantly higher and ACTH levels and plasma renin activity were significantly lower in cases with ATs than in those without. After adjusting for patients’ backgrounds, cortisol levels after the 1-mg DST and plasma renin activity remained significantly different between them. Moreover, cortisol levels after the 1-mg DST and ACTH levels correlated with AT size. Conclusions Apparently nonfunctioning ATs in bilateral PA cases may cause latent autonomous cortisol secretion, inducing diabetes and proteinuria.

Plasma concentrations of atrial natriuretic hormone in acromegaly: Relationship to hypertension

1991 ◽  
Vol 125 (3) ◽  
pp. 268-272 ◽  
Author(s):  
Piotr Soszyński ◽  
Jadwiga Slowińska-Srzednicka ◽  
Stefan Zgliczyński
Keyword(s):  
Plasma Renin Activity ◽  
Plasma Concentrations ◽  
Plasma Renin ◽  
Renin Activity ◽  
Electrolyte Balance ◽  
Natriuretic Hormone ◽  
Hormone Levels ◽  
Atrial Natriuretic Hormone ◽  
The Relationship ◽  
Atrial Natriuretic

Abstract. Atrial natriuretic hormone is involved in the control of blood pressure and water-electrolyte balance. In order to assess the relationship between atrial natriuretic hormone and hypertension in acromegaly, 34 subjects were studied, 18 with acromegaly (10 normotensive and 8 hypertensive) and 16 healthy controls. Plasma atrial natriuretic hormone levels, as well as plasma renin activity, aldosterone and growth hormone levels were measured in basal conditions in all subjects. Additionally, plasma renin activity and aldosterone levels were determined after standard stimulation. In hypertensive acromegalic patients, atrial natriuretic hormone plasma concentrations (39.8±3.5 ng/l) were significantly higher than in patients without hypertension (27.9±4.1 ng/l), and in controls (28.6±1.3 ng/l) (p<0.01 in both comparisons). Stimulated plasma renin activity values were decreased in hypertensive acromegalic patients when compared with those in normotensive patients (1.14±0.29 vs 4.03±0.66 μg·l−1 ·h−1, p<0.01). In acromegaly, atrial natriuretic hormone levels correlated with mean arterial pressure (r=0.58, p=0.01). These results suggest that atrial natriuretic hormone plasma levels are slightly increased in patients with acromegaly and hypertension.

scholarly journals Comparison of active renin concentration and plasma renin activity for the diagnosis of primary hyperaldosteronism in patients with an adrenal mass

2004 ◽  
Vol 150 (4) ◽  
pp. 517-523 ◽  
Author(s):  
N Unger ◽  
I Lopez Schmidt ◽  
C Pitt ◽  
MK Walz ◽  
T Philipp ◽  
...  
Keyword(s):  
Plasma Renin Activity ◽  
Screening Method ◽  
Plasma Renin ◽  
Renin Activity ◽  
Primary Hyperaldosteronism ◽  
Receiver Operating Curve ◽  
Adrenal Tumors ◽  
Plasma Aldosterone Concentration ◽  
Active Renin ◽  
Design And Methods

OBJECTIVE: Plasma aldosterone concentration (PAC) to plasma renin activity (PRA) ratio is an established screening test for primary hyperaldosteronism. Due to the increased recognition of adrenal incidentalomas, reliable parameters are required. Determination of active renin concentration (ARC) in contrast to PRA offers advantages with regard to processing and standardization. The present study compared PRA and ARC under random conditions to establish thresholds for the diagnosis of primary hyperaldosteronism. DESIGN AND METHODS: Fifty patients with various adrenal tumors, including ten patients with aldosterone-secreting adrenal adenomas, as well as ten hypertensive patients and 23 normotensive volunteers were studied. PAC and PRA were measured by radioimmunoassay. ARC was determined by an immunoluminometric assay. RESULTS: Receiver operating curve (ROC) analysis suggested a PAC to ARC ratio threshold of 90 ((ng/l)/(ng/l)) (sensitivity 100%, specificity 98.6%) and a ratio threshold of 62 by additional consideration of PAC > or =200 ng/l (sensitivity 100%, specificity 100%) for the diagnosis of aldosterone-secreting adrenal adenomas. CONCLUSIONS: A PAC to ARC ratio of > or =62 in patients with PAC levels > or =200 ng/l is a reliable screening method for primary hyperaldosteronism in patients with an aldosterone-producing adenoma under random conditions. Because of its advantages with regard to probe processing and its independence from endogenous angiotensinogen levels, ARC may be preferred to PRA.

Effects of an acute calcium load on plasma ACTH, cortisol, aldosterone and renin activity in man

1984 ◽  
Vol 105 (2) ◽  
pp. 251-257 ◽  
Author(s):  
Roland Isaac ◽  
Jean-Paul Raymond ◽  
Muriel Rainfray ◽  
Raymond Ardaillou
Keyword(s):  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Plasma Aldosterone ◽  
Renin Activity ◽  
Cortisol Secretion ◽  
Plasma Acth ◽  
Aldosterone Secretion ◽  
Cortisol Responses ◽  
Calcium Load

Abstract. Plasma adrenocorticotrophin (ACTH), cortisol and aldosterone increased during and after iv administration of calcium gluconate in 4 normal subjects, one patient with hypoparathyroidism and one patient with hypothyroidism. On the other hand, there was a decrease in plasma renin activity but only in the normal subjects. Plasma ACTH and cortisol responses to calcium were abolished whereas plasma aldosterone response persisted in 2 normal subjects pre-treated with dexamethasone. The results observed after calcium administration were compared to those observed after infusion of the solvent only in 6 normal subjects and 4 thyroidectomized patients who were studied twice at 3 day intervals. Plasma ACTH, cortisol and aldosterone were higher when calcium was administered. Plasma renin activity was not statistically different whether or not calcium had been injected in the subjects studied twice. These results demonstrate a direct effect of calcium on ACTH and aldosterone secretion which is not mediated by calcitonin and parathyroid hormone. The stimulatory effect of calcium on cortisol secretion depends on the increase in plasma ACTH.

VARIATIONS IN PLASMA RENIN ACTIVITY AND URINARY ALDOSTERONE EXCRETION IN NORMAL SUBJECTS AFTER SALT RESTRICTION AND ACUTE PITUITARY INHIBITION WITH 6-DEHYDRO-16-METHYLENE HYDROCORTISONE

1971 ◽  
Vol 67 (1) ◽  
pp. 159-173
Author(s):  
A. Peytremann ◽  
R. Veyrat ◽  
A. F. Muller
Keyword(s):  
Plasma Renin Activity ◽  
Salt Intake ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Inhibitory Effect ◽  
Renin Activity ◽  
Sodium Balance ◽  
Experimental Conditions ◽  
Salt Restriction ◽  
Aldosterone Production

ABSTRACT Variations in plasma renin activity and urinary aldosterone excretion were studied in normal subjects submitted to salt restriction and simultaneous inhibition of ACTH production with a new synthetic steroid, 6-dehydro-16-methylene hydrocortisone (STC 407). At a dose of 10 mg t. i. d. this preparation exerts an inhibitory effect on the pituitary comparable to that of 2 mg of dexamethasone. In subjects maintained on a restricted salt intake, STC 407 does not delay the establishment of an equilibrium in sodium balance. The increases in endogenous aldosterone production and in plasma renin activity are also similar to those seen in the control subjects. A possible mineralocorticoid effect of STC 407 can be excluded. Under identical experimental conditions, the administration of dexamethasone yielded results comparable to those obtained with STC 407.

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