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Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
Hidenori Fukuoka
Kobe University Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9255-653X
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View the published version at BMC Endocrine Disorders.
Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).
Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.
Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.
Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.
Trial registration This study was not registered because of the retrospective analysis.
Keywords
Pheochromocytoma, adrenal incidentaloma, renin, aldosterone, ARR
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This preprint is under consideration at BMC Endocrine Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports
Hidenori Fukuoka
Kobe University Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9255-653X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 02 Sep, 2020
Published
On 11 Sep, 2020
No community comments so far
Editorial decision: Accept
On 31 Aug, 2020
Editor assigned
On 30 Aug, 2020
Submission checks complete
On 29 Aug, 2020
Editor invited
On 29 Aug, 2020
No comments provided
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 06 Aug, 2020
Review #2 received
Received 23 Jul, 2020
Reviewer #2 agreed
On 28 Jun, 2020
Review #1 received
Received 07 May, 2020
Reviewer #1 agreed
On 28 Apr, 2020
Reviewers invited
Invitations sent on 23 Apr, 2020
Editor assigned
On 21 Apr, 2020
Submission checks complete
On 20 Apr, 2020
Editor invited
On 20 Apr, 2020
No comments provided
Editorial decision: Major revision
On 20 Mar, 2020
Review #2 received
Received 16 Mar, 2020
Reviewer #2 agreed
On 05 Mar, 2020
Review #1 received
Received 02 Mar, 2020
Reviewer #1 agreed
On 18 Feb, 2020
Reviewers invited
Invitations sent on 10 Feb, 2020
Editor assigned
On 15 Jan, 2020
First submitted
On 14 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Endocrinology & Metabolism
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Endocrine Disorders.
Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).
Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.
Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.
Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.
Trial registration This study was not registered because of the retrospective analysis.
Figure 1
Figure 2
Figure 3