TY - JOUR
T1 - Obesity and the diagnostic accuracy for primary aldosteronism
AU - Tirosh, Amit
AU - Hannah-Shmouni, Fady
AU - Lyssikatos, Charalampos
AU - Belyavskaya, Elena
AU - Zilbermint, Mihail
AU - Abraham, Smita B.
AU - Lodish, Maya B.
AU - Stratakis, Constantine A.
N1 - Publisher Copyright:
©2017 Wiley Periodicals, Inc.
PY - 2017/8
Y1 - 2017/8
N2 - The effects of body mass index on the diagnostic accuracy of primary aldosteronism (PA) are inconsistent and yet important considering the high prevalence and frequent co-occurrence of obesity and hypertension. The current study included 59 adult patients who underwent a stepwise evaluation for PA, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and/or 24-hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U-shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test. Among patients with a body mass index ≥30 kg/m2, the aldosterone to renin ratio yielded lower case detection accuracy of PA. We conclude that obesity results in a nonlinear correlation with plasma aldosterone concentration, plasma renin activity, and aldosterone to renin ratio, which affects the accuracy of case detection for PA. Patients with a body mass index ≥30 kg/m2 are less accurately identified as having PA when saline suppression and/or oral salt loading tests are used for case confirmation.
AB - The effects of body mass index on the diagnostic accuracy of primary aldosteronism (PA) are inconsistent and yet important considering the high prevalence and frequent co-occurrence of obesity and hypertension. The current study included 59 adult patients who underwent a stepwise evaluation for PA, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and/or 24-hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U-shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test. Among patients with a body mass index ≥30 kg/m2, the aldosterone to renin ratio yielded lower case detection accuracy of PA. We conclude that obesity results in a nonlinear correlation with plasma aldosterone concentration, plasma renin activity, and aldosterone to renin ratio, which affects the accuracy of case detection for PA. Patients with a body mass index ≥30 kg/m2 are less accurately identified as having PA when saline suppression and/or oral salt loading tests are used for case confirmation.
UR - http://www.scopus.com/inward/record.url?scp=85020389960&partnerID=8YFLogxK
U2 - 10.1111/jch.13041
DO - 10.1111/jch.13041
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C2 - 28612447
AN - SCOPUS:85020389960
SN - 1524-6175
VL - 19
SP - 790
EP - 797
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 8
ER -