{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T13:51:02Z","timestamp":1767016262898,"version":"3.37.3"},"reference-count":31,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Changi Health Fund"},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council, Singapore","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,20]]},"abstract":"Abstract<\/jats:title>\n \n Context<\/jats:title>\n Obstructive sleep apnea (OSA) is associated with increased nocturnal sympathetic activity. In OSA patients, elevations in metanephrines may lead to false-positive tests when evaluating for pheochromocytoma or paraganglioma (PPGL).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether morning plasma metanephrines would lead to fewer false-positive results than 24-hour urinary metanephrines in OSA patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients undergoing polysomnography for suspected OSA were recruited. Plasma free and 24-hour urinary metanephrines were measured by HPLC-MS\/MS. Patients with elevated levels had repeat measurements, abdominal imaging, and follow-up to diagnose or exclude a PPGL.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Seventy-six patients completed polysomnography and biochemical testing; 68 (89.5%) patients had OSA, of whom 19 (27.9%) had elevated plasma and\/or urinary metanephrines. On follow-up, one patient had a bladder paraganglioma, while PPGL was excluded in the remaining patients. OSA patients had more false-positive urinary metanephrines (17 of 67, 25.4%) than plasma metanephrines (2 of 67, 3.0%), P &lt; .01, and this was more common in severe OSA (13 of 34, 38.2%), compared to moderate\/mild OSA (4 of 33, 12.1%), P &lt; .01. Both plasma and urinary metanephrines decreased after treatment with continuous positive airway pressure. On multivariable analysis, severe OSA, obesity, and family history of hypertension were positive predictors for false-positive urinary metanephrines in patients with suspected OSA.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In OSA patients, plasma metanephrines are less likely to yield false-positive results for the diagnosis of PPGL than 24-hour urinary metanephrines. In patients with suspected OSA, obesity, or a family history of hypertension, plasma metanephrines may be the preferred first-line test to avoid unnecessary anxiety or follow-up.<\/jats:p>\n <\/jats:sec>","DOI":"10.1210\/clinem\/dgad553","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T13:23:59Z","timestamp":1694870639000},"page":"844-851","source":"Crossref","is-referenced-by-count":5,"title":["Plasma Metanephrines Yield Fewer False-Positive Results Than Urine Metanephrines in Patients With Obstructive Sleep Apnea"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-3433","authenticated-orcid":false,"given":"Thomas F J","family":"King","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Changi General Hospital , Singapore 529889 , Singapore"},{"name":"Duke-National University of Singapore (NUS) Medical School, National University of Singapore , Singapore 169547 , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingjuan","family":"Mok","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Changi General Hospital , Singapore 529889 , Singapore"},{"name":"Department of Sleep Medicine, Surgery and Science, Changi General Hospital , Singapore 529889 , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lily Mae","family":"Dacay","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Changi General Hospital , Singapore 529889 , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang Siang","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Changi General Hospital , Singapore 529889 , Singapore"},{"name":"Department of Sleep Medicine, Surgery and Science, Changi General Hospital , Singapore 529889 , 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