{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:14:18Z","timestamp":1787318058777,"version":"build-2736575974"},"reference-count":30,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["19K08996"],"award-info":[{"award-number":["19K08996"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>There are inconsistent results and insufficient evidence as to whether an association exists between the size and aldosterone-producing ability of aldosterone-producing adenomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We further investigated this possible association retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 142 cases of primary aldosteronism diagnosed as unilateral by adrenal venous sampling at 2 referral centers between 2009 and 2019 were included. We classified these individuals into small and large tumor groups using a diameter of 14\u2005mm as a cutoff. This size was the median diameter of the tumor on the affected side of the adrenal gland. We compared plasma aldosterone concentration (PAC), plasma renin activity (PRA), PAC to PRA ratio, PAC from a saline infusion test (SIT), urinary aldosterone secretion (uAld), and serum potassium as indices of aldosterone-producing ability between the 2 groups. In some cases, we conducted histopathological evaluations and detection of the KCNJ5 mutation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PAC, PAC to PRA ratio, PAC from SIT, and uAld were higher and serum potassium was lower in the large tumor group. PAC, PAC from SIT, uAld, and serum potassium significantly correlated with tumor diameter. PRA was not associated with tumor diameter. Clear cell\u2013dominant cases were more common in the large tumor group, while cases showing a strong expression of CYP11B2 were not significantly different between the groups. KCNJ5 mutations tended to be more common in the large tumor group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The higher aldosterone-producing ability in larger adenomas can be used to infer the responsible lesion and disease type.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgac530","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T14:29:26Z","timestamp":1662647366000},"page":"3045-3054","source":"Crossref","is-referenced-by-count":8,"title":["Aldosterone-Producing Adenomas of Increased Size Are Associated With Higher Steroidogenic Activity"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5857-3117","authenticated-orcid":false,"given":"Kazuki","family":"Nakai","sequence":"first","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"},{"name":"Endocrinology and Diabetes Center, Yokohama Rosai Hospital , Yokohama, 222-0036 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Manaka","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichiro","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tohoku University Graduate School of Medicine , Sendai, 980-8575 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6600-8641","authenticated-orcid":false,"given":"Hironobu","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tohoku University Graduate School of Medicine , Sendai, 980-8575 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5831-3286","authenticated-orcid":false,"given":"Yuya","family":"Tsurutani","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Center, Yokohama Rosai Hospital , Yokohama, 222-0036 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Saito","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Center, Yokohama Rosai Hospital , Yokohama, 222-0036 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-7368","authenticated-orcid":false,"given":"Tetsuo","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Center, Yokohama Rosai Hospital , Yokohama, 222-0036 , Japan"},{"name":"Nishikawa Clinic , Yokohama, 222-0033 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taroh","family":"Iiri","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"},{"name":"Department of Pharmacology, St. Marianna University School of Medicine , Kawasaki, 216-8511 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7401-2934","authenticated-orcid":false,"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-115X","authenticated-orcid":false,"given":"Noriko","family":"Makita","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, The University of Tokyo Hospital , Tokyo, 113-8655 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"issue":"19","key":"2022112301491958100_dgac530-B1","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1093\/eurheartj\/eht534","article-title":"Secondary arterial hypertension: when, who, and how to screen?","volume":"35","author":"Rimoldi","year":"2014","journal-title":"Eur Heart J"},{"key":"2022112301491958100_dgac530-B2","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S2213-8587(17)30135-3","article-title":"Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort","volume":"5","author":"Williams","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"6","key":"2022112301491958100_dgac530-B3","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1210\/endrev\/bnaa008","article-title":"Adrenal incidentaloma","volume":"41","author":"Sherlock","year":"2020","journal-title":"Endocr Rev"},{"issue":"5","key":"2022112301491958100_dgac530-B4","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1007\/BF02470984","article-title":"Primary adrenocortical tumors in autopsy records\u2014a survey of \u201ccumulative reports in Japan\u201d from 1973 to 1984","volume":"21","author":"Kobayashi","year":"1991","journal-title":"Jpn J Surg"},{"issue":"6","key":"2022112301491958100_dgac530-B5","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1507\/endocrj.EJ19-0262","article-title":"Comparison between the clinical characteristics of patients with adrenal incidentalomas and those with hypertension-associated adrenal tumors in a single center in Japan","volume":"67","author":"Aoe","year":"2020","journal-title":"Endocr J"},{"issue":"2","key":"2022112301491958100_dgac530-B6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1507\/endocrj.EJ18-0486","article-title":"A nationwide survey of adrenal incidentalomas in Japan: the first report of clinical and epidemiological features","volume":"67","author":"Ichijo","year":"2020","journal-title":"Endocr J"},{"issue":"Suppl","key":"2022112301491958100_dgac530-B7","first-page":"1","article-title":"Consensus statement on the clinical practice of primary aldosteronism in Japan [article in Japanese]","volume":"92","author":"Naruse","year":"2016","journal-title":"Folia Endocrinol Japon"},{"issue":"1","key":"2022112301491958100_dgac530-B8","doi-asserted-by":"crossref","first-page":"R19","DOI":"10.1530\/EJE-17-0990","article-title":"Management of endocrine disease: diagnosis and management of primary aldosteronism: the Endocrine Society guideline 2016 revisited","volume":"179","author":"Williams","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2022112301491958100_dgac530-B9","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1210\/jcem.86.3.7287","article-title":"Identification of the etiology of primary aldosteronism with adrenal vein sampling in patients with equivocal computed tomography and magnetic resonance findings: results in 104 consecutive cases","volume":"86","author":"Rossi","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2022112301491958100_dgac530-B10","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.surg.2012.07.007","article-title":"Modification of the protocol for selective adrenal venous sampling results in both a significant increase in the accuracy and necessity of the procedure in the management of patients with primary hyperaldosteronism","volume":"152","author":"Harvey","year":"2012","journal-title":"Surgery"},{"issue":"4","key":"2022112301491958100_dgac530-B11","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1210\/jc.2007-2055","article-title":"Roles of clinical criteria, computed tomography scan, and adrenal vein sampling in differential diagnosis of primary aldosteronism subtypes","volume":"93","author":"Mulatero","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2022112301491958100_dgac530-B12","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1161\/HYPERTENSIONAHA.118.11382","article-title":"Computed tomography and adrenal venous sampling in the diagnosis of unilateral primary aldosteronism","volume":"72","author":"Williams","year":"2018","journal-title":"Hypertension"},{"issue":"3","key":"2022112301491958100_dgac530-B13","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1161\/HYPERTENSIONAHA.119.14341","article-title":"Precise mapping of intra-adrenal aldosterone activities provides a novel surgical strategy for primary aldosteronism","volume":"76","author":"Kitamoto","year":"2020","journal-title":"Hypertension"},{"issue":"11","key":"2022112301491958100_dgac530-B14","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1291\/hypres.29.883","article-title":"Clinical characteristics of aldosterone-producing microadenoma, macroadenoma, and idiopathic hyperaldosteronism in 93 patients with primary aldosteronism","volume":"29","author":"Omura","year":"2006","journal-title":"Hypertens Res"},{"issue":"10","key":"2022112301491958100_dgac530-B15","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1055\/s-0029-1224200","article-title":"Tumor size of Conn's adenoma and comorbidities","volume":"41","author":"Born-Frontsberg","year":"2009","journal-title":"Horm Metab Res"},{"issue":"4","key":"2022112301491958100_dgac530-B16","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1530\/EJE-08-0902","article-title":"Small tumor size as favorable prognostic factor after adrenalectomy in Conn's adenoma","volume":"160","author":"Giacchetti","year":"2009","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2022112301491958100_dgac530-B17","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1210\/jc.2012-3726","article-title":"Histopathological diagnosis of primary aldosteronism using CYP11B2 immunohistochemistry","volume":"98","author":"Nanba","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2022112301491958100_dgac530-B18","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1245\/s10434-011-2121-5","article-title":"What is the best criterion for the interpretation of adrenal vein sample results in patients with primary hyperaldosteronism?","volume":"19","author":"Webb","year":"2012","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"2022112301491958100_dgac530-B19","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1210\/jc.2015-3284","article-title":"Clinical and steroidogenic characteristics of aldosterone-producing adenomas with ATPase or CACNA1D gene mutations","volume":"101","author":"Kitamoto","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2022112301491958100_dgac530-B20","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1530\/EJE-14-1161","article-title":"Is there a role for segmental adrenal venous sampling and adrenal sparing surgery in patients with primary aldosteronism?","volume":"173","author":"Satoh","year":"2015","journal-title":"Eur J Endocrinol"},{"issue":"11","key":"2022112301491958100_dgac530-B21","first-page":"1157","article-title":"Screening tests and diagnostic examinations of hypertensives for primary aldosteronism [article in Japanese]","volume":"54","author":"Omura","year":"2006","journal-title":"Rinsho Byori"},{"issue":"9","key":"2022112301491958100_dgac530-B22","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":"5","key":"2022112301491958100_dgac530-B23","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1161\/HYPERTENSIONAHA.114.04453","article-title":"Peripheral plasma 18-oxocortisol can discriminate unilateral adenoma from bilateral diseases in primary aldosteronism patients","volume":"65","author":"Satoh","year":"2015","journal-title":"Hypertension"},{"issue":"9","key":"2022112301491958100_dgac530-B24","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1038\/s41440-019-0284-9","article-title":"The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019)","volume":"42","author":"Umemura","year":"2019","journal-title":"Hypertens Res"},{"issue":"3","key":"2022112301491958100_dgac530-B25","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1161\/HYPERTENSIONAHA.118.10907","article-title":"Tumor cell subtypes based on the intracellular hormonal activity in KCNJ5-mutated aldosterone-producing adenoma","volume":"72","author":"Yamazaki","year":"2018","journal-title":"Hypertension"},{"issue":"3","key":"2022112301491958100_dgac530-B26","doi-asserted-by":"crossref","first-page":"e282","DOI":"10.1210\/clinem\/dgz235","article-title":"Histological characterization of aldosterone-producing adrenocortical adenomas with different somatic mutations","volume":"105","author":"Ono","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2022112301491958100_dgac530-B27","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1210\/clinem\/dgaa484","article-title":"International histopathology consensus for unilateral primary aldosteronism","volume":"106","author":"Williams","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2022112301491958100_dgac530-B28","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1161\/HYPERTENSIONAHA.120.16335","article-title":"Steroidogenic activity in unresected adrenals associated with surgical outcomes in primary aldosteronism","volume":"77","author":"Nakai","year":"2021","journal-title":"Hypertension"},{"issue":"9","key":"2022112301491958100_dgac530-B29","doi-asserted-by":"crossref","first-page":"3477","DOI":"10.1210\/jc.2018-00738","article-title":"Aldosterone suppression by dexamethasone in patients with KCNJ5-mutated aldosterone-producing adenoma","volume":"103","author":"Inoue","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2022112301491958100_dgac530-B30","doi-asserted-by":"crossref","first-page":"106116","DOI":"10.1016\/j.jsbmb.2022.106116","article-title":"Phenotype-genotype correlation in aldosterone-producing adenomas characterized by intracellular cholesterol metabolism","volume":"221","author":"Harashima","year":"2022","journal-title":"J Steroid Biochem Mol Biol"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgac530\/46127488\/dgac530.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/107\/11\/3045\/47201345\/dgac530.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/107\/11\/3045\/47201345\/dgac530.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T20:50:18Z","timestamp":1669150218000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/107\/11\/3045\/6694196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,8]]},"references-count":30,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,9,8]]},"published-print":{"date-parts":[[2022,11,23]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgac530","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,9,8]]}}}