Endocrine Abstracts (2011) 26 P31

18-Oxocortisol measurement in adrenal vein sampling as a biomarker for subclassifying primary aldosteronism

F Satoh, Y Nakamura, R Morimoto, M Kudo, K Takase, H Sasano & S Ito


Tohoku University Hospital, Sendai/Miyagi, Japan.


Context: 18-Oxocortisol (18-oxoF) is a derivative of cortisol that is produced by aldosterone synthase (CYP11B2). The potential for this steroid, as a biomarker for differentiating patients with aldosterone-producing adenoma (APA) from those with idiopathic hyperaldosteronism (IHA), has not been examined.

Objectives: We measured 18-oxoF, aldosterone (A) and cortisol (F) in plasma from adrenal vein sampling (AVS) patients. We compared 18-oxoF and 18-oxoF/F and A/F levels for their potential to differentiate APA from IHA.

Design, setting, and subjects: We measured 18-oxoF, F and A in AVS samples obtained from unilateral APAs (14 cases) and bilateral IHAs (7 cases, 14 samples total), using liquid chromatography–mass spectrometry (LC/MS/MS) and RIA analyses, and performed in Tohoku University Hospital.

Results: The levels of 18-oxoF and the ratios of 18-oxoF /F, before and after ACTH stimulation, were significantly higher in blood-draining APAs than in those from the contralateral adrenal gland and from adrenal glands with IHA.

Conclusions: The 18-oxoF levels and ratios of 18-oxoF/F in AVS samples can be a clinically useful biomarker for differentiating APA from IHA and for determining the localization or lateralization of APA in patients with primary aldosteronism.

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