{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:24:37Z","timestamp":1785529477631,"version":"3.56.0"},"reference-count":40,"publisher":"The Endocrine Society","issue":"11","funder":[{"name":"Irene Patricia Hunt Memorial Hypertension Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Current threshold values for primary aldosteronism (PA) diagnostic testing are based on measuring aldosterone (PAC) using immunoassays. Quantification of PAC by liquid chromatography-tandem mass spectrometry (LC-MS\/MS) yields lower values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare aldosterone measurement by radioimmunoassay (RIA) with LC-MS\/MS and evaluate performances of proposed LC-MS\/MS\u2013specific cutoffs for PA screening and confirmatory testing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and Intervention<\/jats:title>\n                  <jats:p>Forty-one patients underwent aldosterone\/renin ratio (ARR) testing to screen for, and fludrocortisone suppression testing (FST) to confirm or exclude, PA. Renin (DRC) was measured by chemiluminescent immunoassay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median serum PACLC-MS\/MS was 27.8% lower (P &amp;lt; 0.05) than plasma PACRIA in 164 pairs of FST samples. A positive correlation (Spearman coefficient, 0.894, P &amp;lt; 0.01; Pearson r coefficient, 0.861, P &amp;lt; 0.01) was observed between the two assays. Thirty-seven patients showed consistent FST diagnoses (29 positive, 8 negative), whereas four showed inconsistent FSTs by the two assays. Good agreement (\u03ba coefficient, 0.736; P &amp;lt; 0.01) was observed between the current FST diagnostic PACRIA cutoff of 165 pmol\/L and the proposed PACLC-MS\/MS cutoff of 133 pmol\/L. Among 37 patients with consistent FST results, no differences were observed in sensitivity (89.7% vs 93.1%) or specificity (87.5% vs 87.5%) for PA screening between the current ARR cutoff of 70 pmol\/mU (PACRIA\/DRC) and the proposed cutoff of 55 pmol\/mU (PACLC-MS\/MS\/DRC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Adjustment of the current cutoffs for PA diagnostic testing is necessary if PAC is measured by LC-MS\/MS. Our preliminary results suggest that the proposed LC-MS\/MS cutoffs for ARR and FST perform as well as current RIA cutoffs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2018-01041","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T18:04:10Z","timestamp":1534788250000},"page":"3965-3973","source":"Crossref","is-referenced-by-count":62,"title":["Aldosterone LC-MS\/MS Assay-Specific Threshold Values in Screening and Confirmatory Testing for Primary Aldosteronism"],"prefix":"10.1210","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2281-6855","authenticated-orcid":false,"given":"Zeng","family":"Guo","sequence":"first","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Poglitsch","sequence":"additional","affiliation":[{"name":"Attoquant Diagnostics, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett C","family":"McWhinney","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus P J","family":"Ungerer","sequence":"additional","affiliation":[{"name":"Department of Chemical Pathology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf H","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Endocrine Hypertension Research Centre, University of Queensland Diamantina 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