Establishment and validation of a prediction model of the right adrenal dominant secretory side in patients with primary hyperaldosteronism
10.3760/cma.j.cn431274-20240303-00358
- VernacularTitle:原发性醛固酮增多症患者右侧肾上腺优势分泌侧预测模型的建立与验证
- Author:
Huasheng LIAO
1
;
Yizhao WU
1
;
Cai DENG
1
;
Lichao ZHANG
1
Author Information
1. 广州医科大学附属第二医院泌尿外科，广州 510220
- Publication Type:Journal Article
- Keywords:
Hyperaldosteronism;
Adrenal glands;
Dominant secretory side;
Prediction model
- From:
Journal of Chinese Physician
2025;27(3):382-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the independent risk factors for predicting the right adrenal dominant secretory side in patients with primary hyperaldosteronism (PHA), so as to construct and verify the prediction model of the dominant secretory side, and provide evidence for the diagnosis and treatment of PHA patients.Methods:Clinical data of 82 PHA patients undergoing adrenal vein sampling (AVS) admitted to the Second Affiliated Hospital of Guangzhou Medical University from January 2015 to July 2023 were retrospectively analyzed, and divided into the training set (58 cases) and the verification set (24 cases) according to the ratio of 7∶3. Single factor and multiple factor logistic regression analysis were used to screen out the risk factors for predicting the right adrenal dominant secretory side, and then combined with the risk factors to build the prediction model of the dominant secretory side. The predictive efficiency and clinical applicability of the predominance secretory nomogram prediction model were verified by drawing receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA curve).Results:(1) Univariate and multivariate logistic analysis showed that the concentration of aldosterone (ALD2) in inferior vena cava and the results of adrenal CT imaging suggested that the right adrenal unilateral nodule (RJJ) were independent risk factors for the occurrence of right adrenal dominant secretion in PHA patients undergoing AVS (all P<0.05). (2) The area under ROC curve (AUC) corresponding to ALD2 variable was 0.898(95% CI: 0.735 7-0.986 1), and the sensitivity and specificity were 95.2% and 81.1%, respectively. The corresponding AUC of RJJ variable was 0.750(95% CI: 0.683 1-0.976 3), and the sensitivity and specificity were 90.5% and 86.7%, respectively. The AUC of the two variables in the verification set were 0.926 and 0.778, respectively. (3) Calibration curve and DCA curve showed that the prediction model had good consistency and clinical applicability, and can produce good clinical benefits. Conclusions:ALD2 and adrenal CT results suggest that RJJ is an independent risk factor for the prediction of the right adrenal dominant secretory side, and the prediction model based on these risk factors has good predictive efficacy and clinical applicability.
