Serum 18-hydroxycortisol in primary aldosteronism, hypertension, and normotensives.
This study reports the determination of plasma 18-hydroxycortisol (18-OHF) using a new and easy enzyme-linked immunosorbent assay (ELISA) method in primary aldosteronism and compares the values found in essential hypertensives and normotensive controls. In primary aldosteronism, we evaluated usefulness of plasma 18-OHF determination and the dexamethasone suppression test in the diagnosis of glucocorticoid-remediable aldosteronism using the genetic test as the gold standard. We studied 31 primary aldosteronism patients, 101 essential hypertensives, and 102 healthy normotensive controls. The plasma 18-OHF was measured using a biotin-avidin enzyme-linked assay by a new and purified polyclonal antibody. The 18-OHF value in primary aldosteronism was 6.3+/-8.05 nmol/L; this value is significantly higher than the value found in essential hypertensives and normotensive controls (2.81+/-1.42 and 2.70+/-1.41 nmol/L, respectively; P<0.0005). In primary aldosteronism, 4 of 31 patients had 18-OHF levels that were 10 times higher than the normal upper limit (2.983 nmol/L). The dexamethasone suppression test in primary aldosteronism patients was positive (serum aldosterone <4 ng/dL) in 13 of 31 cases. A chimeric CYP11B1/CYP11B2 gene was demonstrated in 4 primary aldosteronism patients, corresponding to the same cases that had higher level of 18-OHF. In conclusion, plasma 18-OHF determination by this ELISA method is reliable for detecting glucocorticoid-remediable aldosteronism, and it does so better than the dexamethasone suppression test.
Mosso
L
L
Department of Endocrinology Faculty of Medicine Pontificia Universidad Católica de Chile, Santiago, Chile.
Gómez-Sánchez
C E
CE
Foecking
M F
MF
Fardella
C
C
D000328:Adult; D019405:Cytochrome P-450 CYP11B2 / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives* / Q000097:blood*; D006929:Hyperaldosteronism / Q000097:blood* / Q000235:genetics; D006973:Hypertension / Q000097:blood* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D013252:Steroid 11-beta-Hydroxylase / Q000235:genetics
D019405:Cytochrome P-450 CYP11B2; D013252:Steroid 11-beta-Hydroxylase; C033689:18-hydroxycortisol; D006854:Hydrocortisone