Trial reportThe Journal of clinical endocrinology and metabolism2021
ACTH Stimulation Maximizes the Accuracy of Peripheral Steroid Profiling in Primary Aldosteronism Subtyping.
Trial report in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Usefulness of steroid profiling in the diagnosis of primary Aldosteronism a systematic review.Endocrine · 2026Pooled it
- Examining aldosterone plasma concentration alterations post-ACTH stimulation in healthy subjects: a systematic literature review and meta-analysis on ACTH's role in aldosterone secretion.Hormones (Athens, Greece) · 2024Pooled it
- ACTH Stimulation Maximizes the Accuracy of Peripheral Steroid Profiling in Primary Aldosteronism Subtyping.The Journal of clinical endocrinology and metabolism · 2021Trial
- Partial pressure of oxygen-guided adrenal venous sampling in primary aldosteronism.The Journal of clinical endocrinology and metabolism · 2026Article
- The role of arachidonic acid metabolites in the subtype classification and pathogenesis of primary aldosteronism.iScience · 2026Article
- The diagnostic role of machine learning models related to visceral fat with sex-specific distribution in subtypes of primary aldosteronism.International journal of medical sciences · 2026Article
- Resolution of paradoxical bilateral aldosterone suppression with mass spectrometry.European journal of endocrinology · 2025Article
- Characterizing the Origins of Primary Aldosteronism.Hypertension (Dallas, Tex. : 1979) · 2025Article
- Review
- Chronic activation of adrenal Gq signaling induces Cyp11b2 expression in the zona fasciculata and hyperaldosteronism.Molecular and cellular endocrinology · 2024Article
- Impact of Conducting Adrenal Venous Sampling in the Morning Versus Afternoon in Primary Aldosteronism.Journal of the Endocrine Society · 2023Article
- Primary Aldosteronism: State-of-the-Art Review.American journal of hypertension · 2022Article
- Lateralization inEndocrinology, diabetes & metabolism · 2022Article
- High Prevalence of Autonomous Aldosterone Production in Hypertension: How to Identify and Treat It.Current hypertension reports · 2022Review
- Dichlorodiphenyltrichloroethane and the Adrenal Gland: From Toxicity to Endocrine Disruption.Toxics · 2021Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
contextAdrenocorticotropic hormone (ACTH) can contribute to aldosterone excess in primary aldosteronism (PA) via increased melanocortin type 2 receptor expression. Dynamic manipulation of the hypothalamic-pituitary-adrenal (HPA) axis could assist PA subtyping, but a direct comparison of dynamic tests is lacking.
objectiveTo investigate plasma steroid differences between aldosterone-producing adenoma (APA) and bilateral PA (BPA) relative to ACTH variations.
methodsWe conducted comprehensive dynamic testing in 80 patients: 40 with APA and 40 with BPA. Peripheral plasma was collected from each patient at 6 time points: morning; midnight; after 1 mg dexamethasone suppression; and 15, 30, and 60 minutes after ACTH stimulation. We quantified 17 steroids by mass spectrometry in response to ACTH variations in all patients and compared their discriminative power between the 2 PA subtypes.
resultsPatients with APA had higher morning and midnight concentrations of 18-hydroxycortisol, 18-oxocortisol, aldosterone, and 18-hydroxycorticosterone than those with BPA (P < 0.001 for all). In response to cosyntropin stimulation, the APA group had larger increments of aldosterone, 18-oxocortisol, 11-deoxycorticosterone, corticosterone, and 11-deoxycortisol (P < 0.05 for all). Following dexamethasone suppression, the APA group had larger decrements of aldosterone, 18-hydroxycortisol, and 18-oxocortisol (P < 0.05 for all), but their concentrations remained higher than in the BPA group (P < 0.01 for all). The highest discriminatory performance between the PA subtypes was achieved using steroids measured 15 minutes post-ACTH stimulation (area under receiver operating characteristic curve 0.957).
conclusionSteroid differences between APA and BPA are enhanced by dynamic HPA testing; such noninvasive tests could circumvent the need for adrenal vein sampling in a subset of patients with PA.
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What OpenQuestion holds
Registered trials
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.