Screening for primary aldosteronism on and off interfering medications

作者全名："Li, Xiaoyu; Liang, Jiayu; Hu, Jinbo; Ma, Linqiang; Yang, Jun; Zhang, Aipin; Jing, Ying; Song, Ying; Yang, Yi; Feng, Zhengping; Du, Zhipeng; Wang, Yue; Luo, Ting; He, Wenwen; Shu, Xiaoyu; Yang, Shumin; Li, Qifu"

作者地址："[Li, Xiaoyu; Liang, Jiayu; Hu, Jinbo; Ma, Linqiang; Jing, Ying; Song, Ying; Yang, Yi; Feng, Zhengping; Du, Zhipeng; Wang, Yue; Luo, Ting; He, Wenwen; Yang, Shumin; Li, Qifu] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China; [Yang, Jun] Monash Univ, Dept Med, Clayton, Vic, Australia; [Yang, Jun] Hudson Inst Med Res, Ctr Endocrinol & Metab, Clayton, Vic, Australia; [Zhang, Aipin] Chongqing Med Univ, Affiliated Hosp 1, Grad Adm Off, Chongqing, Peoples R China; [Shu, Xiaoyu] Capital Med Univ, Beijing Chao Yang Hosp, Dept Endocrinol, Beijing, Peoples R China"

通信作者："Yang, SM; Li, QF (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China.; Shu, XY (通讯作者)，Capital Med Univ, Beijing Chao Yang Hosp, Dept Endocrinol, Beijing, Peoples R China."

来源：ENDOCRINE

ESI学科分类：BIOLOGY & BIOCHEMISTRY

WOS号：WOS:001079120300002

JCR分区：Q2

影响因子：3

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Antihypertensives; Cut-off; Diagnostic accuracy; Primary aldosteronism

摘要："ObjectiveTo determine whether antihypertensives will affect diagnostic accuracy of the aldosterone-to-renin ratio (ARR) to an extent that is clinically relevant.MethodsConfirmatory tests were used to confirm or exclude PA diagnosis. Area under the receiver operating characteristic curve (AUC), specificity and sensitivity of ARR performance in different conditions were calculated.Results208 PA and 78 essential hypertension (EH), and 125 PA and 206 EH patients, were included in the retrospective and prospective cohort, respectively. AUC of ARR on interfering medications was comparable to ARR off interfering medications (retrospective: 0.82 vs. 0.87, p = 0.20; prospective: 0.78 vs. 0.84, p = 0.07). At a threshold of 20 pg/mu IU, the sensitivity of ARR on interfering medications was lower (11.1-23.2%) while the specificity was higher (10.2-15.2%) than ARR off interfering medications. However, when the ARR threshold on interfering medications was lowered to 10 pg/mu IU, both the sensitivity (retrospective: 0.91 vs. 0.90, p = 0.61; prospective: 0.86 vs. 0.82, p = 0.39) and specificity (retrospective: 0.49 vs. 0.59, p = 0.20; prospective: 0.58 vs. 0.66, p = 0.10) were comparable to the ARR threshold off interfering medications.ConclusionUsing ARR to screen for PA whilst taking interfering antihypertensive drugs is feasible in most cases, but the ARR threshold needs to be reduced.Trial registrationClinicalTrials.gov identifier: NCT04991961."

基金机构："National Natural Science Foundation of China [82100833, U21A20355]; Joint Medical Research Project of Chongqing Science and Technology Commission & Chongqing Health and Family Planning Commission [2022ZDXM003]; National Key Research & Development Plan of China [2021YFC2501600, 2021YFC2501603]; National Key Research and Development Project [2022YFC2505300, 2022YFC2505301]"

基金资助正文："This work is supported by the National Natural Science Foundation of China (82100833, U21A20355); Joint Medical Research Project of Chongqing Science and Technology Commission & Chongqing Health and Family Planning Commission (Major Project, 2022ZDXM003); National Key Research & Development Plan of China, major project of prevention and treatment for common diseases (2021YFC2501600, sub-project: 2021YFC2501603). The National Key Research and Development Project (2022YFC2505300, subproject 2022YFC2505301)"