Evidence map›Paper›PMID 34096581›Full record

ArticleClinical chemistry2021

Diagnostic Accuracy of Salivary Metanephrines in Pheochromocytomas and Paragangliomas.

Karin Eijkelenkamp, Thamara E Osinga, Martijn van Faassen, Ido P Kema, Michiel N Kerstens, Karel Pacak, Wim J Sluiter, Thera P Links, Anouk N A van der Horst-Schrivers

Erratum issuedOpen access · bronzeAbstract read
In one paragraph

Article in Clinical chemistry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Karin EijkelenkampDepartment of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Thamara E OsingaDepartment of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Martijn van FaassenDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Ido P KemaDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Michiel N KerstensDepartment of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Karel PacakEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Wim J SluiterDepartment of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Thera P LinksDepartment of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Anouk N A van der Horst-SchriversDepartment of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
University Medical Center Groningen · NLUniversity of Groningen · NLEunice Kennedy Shriver National Institute of Child Health and Human Development · US

Funding

Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentIntramural Research ProgramNIH HHSVon Hippel-Lindau Alliance
6 · The paper itself

Abstract

backgroundMeasurements of plasma free metanephrines are recommended for diagnosing pheochromocytomas and paragangliomas (PPGL). Metanephrines can be detected in saliva with LC-MS/MS with sufficient analytical sensitivity and precision. Because collecting saliva is noninvasive and less cumbersome than plasma or urine sampling, we assessed the diagnostic accuracy of salivary metanephrines in diagnosing PPGL.

methodsThis 2-center study included 118 healthy participants (44 men; mean age: 33 years (range: 19--74 years)), 44 patients with PPGL, and 54 patients suspected of PPGL. Metanephrines were quantified in plasma and saliva using LC-MS/MS. Diagnostic accuracy; correlation between plasma and salivary metanephrines; and potential factors influencing salivary metanephrines, including age, sex, and posture during sampling, were assessed.

resultsSalivary metanephrines were significantly higher in patients with PPGL compared with healthy participants (metanephrine (MN): 0.19 vs 0.09 nmol/L, P < 0.001; normetanephrine (NMN): 2.90 vs 0.49 nmol/L, P < 0.001). The diagnostic sensitivity and specificity of salivary metanephrines were 89% and 87%, respectively. Diagnostic accuracy of salivary metanephrines was 88%, with an area under the ROC curve of 0.880. We found a significant correlation between plasma and salivary metanephrines (Pearson correlation coefficient: MN, 0.86, P < 0.001; NMN, 0.83, P < 0.001). Salivary NMN concentrations were higher when collected in a seated position compared with supine (P < 0.001) and increased with age (P < 0.001).

conclusionsSalivary metanephrines are a promising tool in the biochemical diagnosis of PPGL. Salivary metanephrines correlate with plasma free metanephrines and are increased in patients with PPGL. At this time, however, salivary metanephrines cannot replace measurement of plasma free metanephrines.

Indexed as

Adrenal Gland NeoplasmsParagangliomaPheochromocytomaAdultChromatography, LiquidHumansMaleMetanephrineNormetanephrineTandem Mass SpectrometryMetanephrineNormetanephrine

Identifiers

PMID34096581
PMCPMC8341008
OpenAlexW3169430462

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.