{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:42:42Z","timestamp":1792204962587,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,10,17]],"date-time":"2013-10-17T00:00:00Z","timestamp":1381968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To document the influences of blood sampling under supine fasting versus seated nonfasting conditions on diagnosis of phaeochromocytomas and paragangliomas (<jats:styled-content style=\"fixed-case\">PPGL<\/jats:styled-content>) using plasma concentrations of normetanephrine, metanephrine and methoxytyramine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>Biochemical testing for <jats:styled-content style=\"fixed-case\">PPGL<\/jats:styled-content> was performed on 762 patients at six centres, two of which complied with requirements for supine sampling after an overnight fast and four of which did not. Phaeochromocytomas and paragangliomas were found in 129 patients (67 noncompliant, 62 compliant) and not in 633 patients (195 noncompliant, 438 compliant).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Plasma concentrations of normetanephrine and methoxytyramine did not differ between compliant and noncompliant sampling conditions in patients with <jats:styled-content style=\"fixed-case\">PPGL<\/jats:styled-content> but were 49\u201051% higher in patients without <jats:styled-content style=\"fixed-case\">PPGL<\/jats:styled-content> sampled under noncompliant compared with compliant conditions. The 97\u00b75 percentiles of distributions were also higher under noncompliant compared with compliant conditions for normetanephrine (1\u00b729 <jats:italic>vs<\/jats:italic> 0\u00b779\u00a0nmol\/l), metanephrine (0\u00b749 <jats:italic>vs<\/jats:italic> 0\u00b741\u00a0nmol\/l) and methoxytyramine (0\u00b742 <jats:italic>vs<\/jats:italic> 0\u00b718\u00a0nmol\/l). Use of upper cut\u2010offs established from seated nonfasting sampling conditions resulted in substantially decreased diagnostic sensitivity (98% <jats:italic>vs<\/jats:italic> 85%). In contrast, use of upper cut\u2010offs established from supine fasting conditions resulted in decreased diagnostic specificity for testing under noncompliant compared with compliant conditions (71% <jats:italic>vs<\/jats:italic> 95%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High diagnostic sensitivity of plasma normetanephrine, metanephrine and methoxytyramine for the detection of <jats:styled-content style=\"fixed-case\">PPGL<\/jats:styled-content> can only be guaranteed using upper cut\u2010offs of reference intervals established with blood sampling under supine fasting conditions. With such cut\u2010offs, sampling under seated nonfasting conditions can lead to a 5\u00b77\u2010fold increase in false\u2010positive results necessitating repeat sampling under supine fasting conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12327","type":"journal-article","created":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T13:49:54Z","timestamp":1381240194000},"page":"478-486","source":"Crossref","is-referenced-by-count":107,"title":["Biochemical diagnosis of phaeochromocytoma using plasma\u2010free normetanephrine, metanephrine and methoxytyramine: importance of supine sampling under fasting conditions"],"prefix":"10.1111","volume":"80","author":[{"given":"Roland","family":"D\u00e4rr","sequence":"first","affiliation":[{"name":"Department of Medicine III University Hospital Dresden at the TU Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Pamporaki","sequence":"additional","affiliation":[{"name":"Department of Medicine III University Hospital Dresden at the TU Dresden Dresden Germany"},{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Hospital Dresden at the TU Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Peitzsch","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Hospital Dresden at the TU Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstanze","family":"Miehle","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nephrology University Hospital Leipzig Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Prejbisz","sequence":"additional","affiliation":[{"name":"Department of Hypertension Institute of Cardiology Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariola","family":"Peczkowska","sequence":"additional","affiliation":[{"name":"Department of Hypertension Institute of Cardiology Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Weismann","sequence":"additional","affiliation":[{"name":"Endocrine and Diabetes Unit University Hospital Wurzburg Wurzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Endocrine Research Unit Medical Clinic Innenstadt \u2013 LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sinnott","sequence":"additional","affiliation":[{"name":"Department of Computing and Information Systems University of Melbourne Melbourne Vic. 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