Serum 18-hydroxycortisol in primary aldosteronism, hypertension, and normotensives
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Date
2001
Journal Title
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Volume Title
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Abstract
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.
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Keywords
18-hydroxycortisol, hypertension, mineralocorticoid, glucocorticoids, aldosterone, GLUCOCORTICOID-REMEDIABLE ALDOSTERONISM, SUPPRESSIBLE HYPERALDOSTERONISM, CHIMERIC GENE, 18-OXOCORTISOL, DIAGNOSIS, DEXAMETHASONE, PHENOTYPE, EXCRETION, STEROIDS, BINDING