Value of combination strategy based on plasma aldosterone/renin concentration ratio in screening of primary aldosteronism
10.7644/j.issn.1674-9960.2015.04.011
- VernacularTitle:基于血浆醛固酮／肾素浓度比的联合策略在原发性醛固酮增多症中的筛查价值
- Author:
Mingfang SUN
;
Shan YANG
;
Xiaoqun HE
;
Bo ZHOU
;
Qifu LI
;
Yaqian DUAN
- Publication Type:Journal Article
- Keywords:
plasma aldosterone concentration;
plasma renin concentration;
primary aldosteronism;
screening test
- From:
Military Medical Sciences
2015;(4):279-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the best way for clinical screening of primary aldosteronism (PA).Methods Three hundred and three suspected cases of PA were collected and divided into groups of primary aldosteronism group, essential hypertension group, and nonsecreting cortical adrenal tumor group.The plasma aldosterone concentration/plasma renin concentration ratio ( ARR) was used to draw the receiver operating characteristic ( ROC) curve and obtain the best cut-off point.Furthermore, the current screening schemes for PA were compared.Results Upright ARR yield had larger areas under the ROC curve than plasma aldosterone concentration or plasma renin concentration under all conditions of testing. The best cut-off point of upright ARR[(pg/ml)/(μIU/ml)] for the diagnosis of PA was 43.45.During the two postural stimulation tests,the two upright ARR exceeded 43.45 with the highest diagnostic sensitivity of PA reaching 0.94.During the two upright tests ARR was less than 43.45, with a sensitivity of 0.74, and a specificity of 0.94.Conclusion To screen for PA in high-risk populations, twice postural stimulation test is recommended.As long as the upright ARR is above 43.45, PA may be considered and further confirmation is needed to prevent misdiagnosis.
