{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:38:52Z","timestamp":1773329932916,"version":"3.50.1"},"reference-count":33,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T00:00:00Z","timestamp":1604880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"JSPS KAKENHI","award":["JP20K17493"],"award-info":[{"award-number":["JP20K17493"]}]},{"name":"JSPS KAKENHI","award":["JP20K17514"],"award-info":[{"award-number":["JP20K17514"]}]},{"DOI":"10.13039\/501100005928","name":"Daiwa Securities Health Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005928","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007206","name":"Kaibara Morikazu Medical Science Promotion Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007206","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008695","name":"Japan Foundation for Applied Enzymology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008695","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Current clinical guidelines recommend confirmation of a positive result in at least one confirmatory test in the diagnosis of primary aldosteronism (PA). Clinical implication of multiple confirmatory tests has not been established, especially when patients show discordant results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of the present study was to explore the role of 2 confirmatory tests in subtype diagnosis of PA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and Setting<\/jats:title>\n                  <jats:p>A retrospective cross-sectional study was conducted at two referral centers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants and Methods<\/jats:title>\n                  <jats:p>We identified 360 hypertensive patients who underwent both a captopril challenge test (CCT) and a saline infusion test (SIT) and exhibited at least one positive result. Among them, we studied 193 patients with PA whose data were available for subtype diagnosis based on adrenal vein sampling (AVS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure<\/jats:title>\n                  <jats:p>The prevalence of bilateral subtype on AVS according to the results of the confirmatory tests was measured.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of patients studied, 127 were positive for both CCT and SIT (double-positive), whereas 66 were positive for either CCT or SIT (single-positive) (n\u2005=\u200534 and n\u2005=\u200532, respectively). Altogether, 135 were diagnosed with bilateral subtype on AVS. The single-positive patients had milder clinical features of PA than the double-positive patients. The prevalence of bilateral subtype on AVS was significantly higher in the single-positive patients than in the double-positive patients. (63\/66 [95.5%] vs 72\/127 [56.7%], P\u2005&amp;lt;\u2005.01). Several clinical parameters were different between CCT single-positive and SIT single-positive patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with discordant results between CCT and SIT have a high probability of bilateral subtype of PA on AVS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa812","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T17:22:35Z","timestamp":1604942555000},"page":"e866-e874","source":"Crossref","is-referenced-by-count":15,"title":["Significance of Discordant Results Between Confirmatory Tests in Diagnosis of Primary Aldosteronism"],"prefix":"10.1210","volume":"106","author":[{"given":"Tazuru","family":"Fukumoto","sequence":"first","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4293-287X","authenticated-orcid":false,"given":"Hironobu","family":"Umakoshi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Ogata","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maki","family":"Yokomoto-Umakoshi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yayoi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misato","family":"Motoya","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yui","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norifusa","family":"Iwahashi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2020,11,9]]},"reference":[{"issue":"3","key":"2021122205335179100_CIT0001","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1210\/jc.2003-031337","article-title":"Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents","volume":"89","author":"Mulatero","year":"2004","journal-title":"J Clin Endocrinol Metab."},{"issue":"11","key":"2021122205335179100_CIT0002","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1016\/j.jacc.2006.07.059","article-title":"A prospective study of the prevalence of primary aldosteronism in 1125 hypertensive patients","volume":"48","author":"Rossi","year":"2006","journal-title":"J Am Coll Cardiol."},{"issue":"3","key":"2021122205335179100_CIT0003","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1055\/s-0031-1295438","article-title":"Prevalence of primary aldosteronism in patient\u2019s cohorts and in population-based studies\u2014a review of the current literature","volume":"44","author":"Hannemann","year":"2012","journal-title":"Horm Metab Res."},{"key":"2021122205335179100_CIT0004","doi-asserted-by":"crossref","first-page":"162804","DOI":"10.4061\/2011\/162804","article-title":"Changes in the perceived epidemiology of primary hyperaldosteronism","volume":"2011","author":"Fagugli","year":"2011","journal-title":"Int J Hypertens."},{"issue":"3","key":"2021122205335179100_CIT0005","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1161\/HYPERTENSIONAHA.112.197111","article-title":"Observational study mortality in treated primary aldosteronism: the German Conn\u2019s registry","volume":"60","author":"Reincke","year":"2012","journal-title":"Hypertension."},{"issue":"3","key":"2021122205335179100_CIT0006","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1161\/HYPERTENSIONAHA.117.10263","article-title":"Prevalence of cardiovascular disease and its risk factors in primary aldosteronism: a multicenter study in Japan","volume":"71","author":"Ohno","year":"2018","journal-title":"Hypertension."},{"issue":"8","key":"2021122205335179100_CIT0007","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.jacc.2005.01.015","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism","volume":"45","author":"Milliez","year":"2005","journal-title":"J Am Coll Cardiol."},{"issue":"12","key":"2021122205335179100_CIT0008","doi-asserted-by":"crossref","first-page":"4826","DOI":"10.1210\/jc.2013-2805","article-title":"Long-term cardio- and cerebrovascular events in patients with primary aldosteronism","volume":"98","author":"Mulatero","year":"2013","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2021122205335179100_CIT0009","doi-asserted-by":"crossref","first-page":"dgz017","DOI":"10.1210\/clinem\/dgz017","article-title":"Subtyping of primary aldosteronism in the AVIS-2 study: assessment of selectivity and lateralization","volume":"105","author":"Rossitto","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2021122205335179100_CIT0010","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2021122205335179100_CIT0011","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/hr.2014.20","article-title":"The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2014)","volume":"37","author":"Shimamoto","year":"2014","journal-title":"Hypertens Res."},{"issue":"9","key":"2021122205335179100_CIT0012","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1507\/endocrj.EJ11-0133","article-title":"Guidelines for the diagnosis and treatment of primary aldosteronism\u2014the Japan Endocrine Society 2009","volume":"58","author":"Nishikawa","year":"2011","journal-title":"Endocr J."},{"issue":"2","key":"2021122205335179100_CIT0013","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1161\/HYPERTENSIONAHA.107.091827","article-title":"Comparison of the captopril and the saline infusion test for excluding aldosterone-producing adenoma","volume":"50","author":"Rossi","year":"2007","journal-title":"Hypertension."},{"issue":"6","key":"2021122205335179100_CIT0014","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1161\/01.HYP.37.6.1440","article-title":"Captopril suppression versus salt loading in confirming primary aldosteronism","volume":"37","author":"Agharazii","year":"2001","journal-title":"Hypertension."},{"key":"2021122205335179100_CIT0015","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1210\/clinem\/dgz148","article-title":"Role of aldosterone and potassium levels in sparing confirmatory tests in primary aldosteronism","volume":"105","author":"Umakoshi","year":"2020","journal-title":"J Clin Endocrinol Metab."},{"key":"2021122205335179100_CIT0016","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1210\/js.2018-00055","article-title":"Correlation between the lateralization index of adrenal venous sampling and standardized outcome in primary aldosteronism","volume":"2","author":"Umakoshi","year":"2018","journal-title":"J Endocr Soc"},{"issue":"3","key":"2021122205335179100_CIT0017","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transplant."},{"issue":"10008","key":"2021122205335179100_CIT0018","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1016\/S0140-6736(15)00257-3","article-title":"Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial","volume":"386","author":"Williams","year":"2015","journal-title":"Lancet."},{"issue":"1","key":"2021122205335179100_CIT0019","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7326\/M20-0065","article-title":"The unrecognized prevalence of primary aldosteronism: a cross-sectional study","volume":"173","author":"Brown","year":"2020","journal-title":"Ann Intern Med."},{"issue":"6","key":"2021122205335179100_CIT0020","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1210\/er.2018-00139","article-title":"The expanding spectrum of primary aldosteronism: implications for diagnosis, pathogenesis, and treatment","volume":"39","author":"Vaidya","year":"2018","journal-title":"Endocr Rev."},{"issue":"6","key":"2021122205335179100_CIT0021","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/cen.14111","article-title":"Seated saline infusion test in predicting subtype diagnosis of primary aldosteronism","volume":"91","author":"Kaneko","year":"2019","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"8","key":"2021122205335179100_CIT0022","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.1210\/jc.2014-1153","article-title":"Seated saline suppression testing for the diagnosis of primary aldosteronism: a preliminary study","volume":"99","author":"Ahmed","year":"2014","journal-title":"J Clin Endocrinol Metab."},{"issue":"11","key":"2021122205335179100_CIT0023","doi-asserted-by":"crossref","first-page":"4113","DOI":"10.1210\/jc.2018-01394","article-title":"Comparison of seated with recumbent saline suppression testing for the diagnosis of primary aldosteronism","volume":"103","author":"Stowasser","year":"2018","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2021122205335179100_CIT0024","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1530\/EJE-19-0138","article-title":"Safety of medical adjustment and confirmatory testing in the diagnostic work-up of primary aldosteronism","volume":"181","author":"Heinrich","year":"2019","journal-title":"Eur J Endocrinol."},{"issue":"12","key":"2021122205335179100_CIT0025","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1038\/hr.2014.129","article-title":"The influence of aging on the diagnosis of primary aldosteronism","volume":"37","author":"Nakama","year":"2014","journal-title":"Hypertens Res."},{"issue":"2","key":"2021122205335179100_CIT0026","doi-asserted-by":"crossref","first-page":"E546","DOI":"10.3390\/ijms19020546","article-title":"The low-renin hypertension phenotype: genetics and the role of the mineralocorticoid receptor","volume":"19","author":"Baudrand","year":"2018","journal-title":"Int J Mol Sci."},{"key":"2021122205335179100_CIT0027","doi-asserted-by":"crossref","first-page":"8647026","DOI":"10.1155\/2018\/8647026","article-title":"Age-related cutoffs of plasma aldosterone\/renin concentration for primary aldosteronism screening","volume":"2018","author":"Ma","year":"2018","journal-title":"Int J Endocrinol."},{"issue":"22","key":"2021122205335179100_CIT0028","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1161\/CIRCULATIONAHA.115.018226","article-title":"Adipocyte-derived hormone leptin is a direct regulator of aldosterone secretion, which promotes endothelial dysfunction and cardiac fibrosis","volume":"132","author":"Huby","year":"2015","journal-title":"Circulation."},{"issue":"5","key":"2021122205335179100_CIT0029","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1096\/fj.07-9412com","article-title":"A novel adipokine CTRP1 stimulates aldosterone production","volume":"22","author":"Jeon","year":"2008","journal-title":"FASEB J."},{"issue":"4","key":"2021122205335179100_CIT0030","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/1047-2797(91)90040-J","article-title":"Obesity, blood pressure, and the sympathetic nervous system","volume":"1","author":"Landsberg","year":"1991","journal-title":"Ann Epidemiol."},{"issue":"7","key":"2021122205335179100_CIT0031","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1038\/ajh.2012.47","article-title":"Plasma aldosterone is increased in class 2 and 3 obese essential hypertensive patients despite drug treatment","volume":"25","author":"Sarzani","year":"2012","journal-title":"Am J Hypertens."},{"issue":"1","key":"2021122205335179100_CIT0032","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1161\/HYPERTENSIONAHA.117.10197","article-title":"Confirmatory tests for the diagnosis of primary aldosteronism: a prospective diagnostic accuracy study","volume":"71","author":"Song","year":"2018","journal-title":"Hypertension."},{"issue":"2","key":"2021122205335179100_CIT0033","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S0889-8529(18)30425-0","article-title":"Primary aldosteronism. Diagnostic evaluation","volume":"17","author":"Young","year":"1988","journal-title":"Endocrinol Metab Clin North Am."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa812\/34788068\/dgaa812.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/2\/e866\/41849633\/dgaa812.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/2\/e866\/41849633\/dgaa812.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T05:40:22Z","timestamp":1640151622000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/106\/2\/e866\/5963911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,9]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,11,9]]},"published-print":{"date-parts":[[2021,1,23]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa812","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2,1]]},"published":{"date-parts":[[2020,11,9]]}}}