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The current study included 59 adult patients who underwent a stepwise evaluation for <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and\/or 24\u2010hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U\u2010shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test. Among patients with a body mass index \u226530\u00a0kg\/m<jats:sup>2<\/jats:sup>, the aldosterone to renin ratio yielded lower case detection accuracy of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. We conclude that obesity results in a nonlinear correlation with plasma aldosterone concentration, plasma renin activity, and aldosterone to renin ratio, which affects the accuracy of case detection for <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. Patients with a body mass index \u226530\u00a0kg\/m<jats:sup>2<\/jats:sup> are less accurately identified as having PA when saline suppression and\/or oral salt loading tests are used for case confirmation.<\/jats:p>","DOI":"10.1111\/jch.13041","type":"journal-article","created":{"date-parts":[[2017,6,14]],"date-time":"2017-06-14T04:12:50Z","timestamp":1497413570000},"page":"790-797","source":"Crossref","is-referenced-by-count":14,"title":["Obesity and the diagnostic accuracy for primary aldosteronism"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3794-9634","authenticated-orcid":false,"given":"Amit","family":"Tirosh","sequence":"first","affiliation":[{"name":"Section on Endocrinology and Genetics <i>Eunice Kennedy Shriver<\/i> National Institute of Child Health and Human Development, National Institutes of Health  Bethesda MD USA"},{"name":"Sackler Faculty of Medicine Tel Aviv University  Tel Aviv 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