{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:08:09Z","timestamp":1789477689865,"version":"build-2803163510"},"reference-count":29,"publisher":"Walter de Gruyter GmbH","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2026-0579_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The high variability in screening and confirmatory cut-off values for primary aldosteronism (PA) largely\u00a0reflects the insufficient standardization of current analytical methods. Competitive and sandwich immunoassays show variable correlation with the reference liquid chromatography-tandem mass spectrometry (LC-MS\/MS) technique. This prospective multicenter study aimed to establish diagnostic thresholds for PA using a novel sandwich immunoassay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0579_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 676 patients suspected of PA were consecutively enrolled from 7 medical centers in China. All participants underwent a captopril challenge test (CCT), followed by a seated saline infusion test (sSIT) on the third day. Plasma aldosterone concentration (PAC) and plasma renin concentration (PRC) were measured using a fully automated chemiluminescent immunoassay platform (Maglumi X8, SNIBE, China). PA was diagnosed according to current clinical guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0579_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An aldosterone renin ratio (ARR) cut-off of 11\u202fng\/L\/mU\/L showed 90\u202f% sensitivity (95\u202f% CI: 85\u201394\u202f%) and 62\u202f% specificity (95\u202f% CI: 58\u201367\u202f%) with the area under the receiver-operator characteristic curves (AUC) of 0.843 (95\u202f% CI: 0.81\u20130.87). PAC post-sSIT and PAC post-CCT exhibited comparable diagnostic performance (AUC 0.818, 95\u202f% CI: 0.79\u20130.85 vs. AUC 0.848, 95\u202f% CI: 0.82\u20130.88; p=0.1388). Using cut-off of 56\u202fng\/L and 59\u202fng\/L for post-SIT and post-CCT yielded a specificity of 85\u202f% (95\u202f% CI: 81\u201388\u202f%). Notably, to achieve a higher specificity of 90\u202f%, the corresponding PAC\u00a0cut-off values increased to 64\u202fng\/L post-SIT and 66\u202fng\/L post-CCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0579_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjustment of current cut-off values for the screening and confirmation of PA is necessary when a more accurate chemiluminescent sandwich immunoassay is used for measuring PAC and\u00a0PRC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2026-0579","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:56:15Z","timestamp":1782363375000},"page":"2018-2025","source":"Crossref","is-referenced-by-count":0,"title":["New insights in primary aldosteronism diagnosis: a prospective multicenter study"],"prefix":"10.1515","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-8563","authenticated-orcid":false,"given":"Kaijuan","family":"Wang","sequence":"first","affiliation":[{"name":"Center of Laboratory Medicine, Beijing Key Laboratory of Cardiovascular Disease Warning and Diagnosis, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College\/National Center for Cardiovascular Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Ma","sequence":"additional","affiliation":[{"name":"Hypertension Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongying","family":"Cong","sequence":"additional","affiliation":[{"name":"Center of Laboratory Medicine, Beijing Key Laboratory of Cardiovascular Disease Warning and Diagnosis, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College\/National Center for Cardiovascular Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Gao","sequence":"additional","affiliation":[{"name":"Center of Laboratory Medicine, Beijing Key Laboratory of Cardiovascular Disease Warning and Diagnosis, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College\/National Center for Cardiovascular Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center of Laboratory Medicine, Beijing Key Laboratory of Cardiovascular Disease Warning and Diagnosis, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College\/National Center for Cardiovascular Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangwei","family":"Gao","sequence":"additional","affiliation":[{"name":"Center of Laboratory Medicine, Beijing Key Laboratory of Cardiovascular Disease Warning and Diagnosis, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College\/National Center for Cardiovascular Diseases , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Hypertension Ward, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences , Kunming , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine , Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences , Kunming , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine , Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences , Kunming , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Cheng","sequence":"additional","affiliation":[{"name":"Hypertension Center, Beijing Anzhen Hospital, Capital Medical University , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Beijing Anzhen Hospital, Capital Medical University , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sufang","family":"Hao","sequence":"additional","affiliation":[{"name":"Hypertension Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houqing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine , Fuwai Shenzhen Hospital, Chinese Academy of Medical Sciences , Shenzhen , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuping","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hypertension , Fuwai Central China Cardiovascular Hospital , Zhengzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poshi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine , Fuwai Central China Cardiovascular Hospital , Zhengzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Coronary Heart Disease Ward, Wuhan Asia Heart Hospital , Wuhan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenlu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine , Wuhan Asia Heart Hospital , Wuhan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyan","family":"Zhou","sequence":"additional","affiliation":[{"name":"National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital\/National Center of 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J\u00a0Hypertens 2016;34:920\u20137. https:\/\/doi.org\/10.1097\/hjh.0000000000000880.","DOI":"10.1097\/HJH.0000000000000880"},{"key":"2026091512595695964_j_cclm-2026-0579_ref_026","doi-asserted-by":"crossref","unstructured":"McEvoy, JW, McCarthy, CP, Bruno, RM, Brouwers, S, Canavan, MD, Ceconi, C, et al.. 2024 ESC guidelines for the management of elevated blood pressure and hypertension: developed by the task force on the management of elevated blood pressure and hypertension of the european society of cardiology (ESC) and endorsed by the european society of endocrinology (ESE) and the european stroke organisation (ESO). Eur Heart J 2024;45:3912\u20134018. https:\/\/doi.org\/10.1093\/eurheartj\/ehae178.","DOI":"10.1093\/eurheartj\/ehae178"},{"key":"2026091512595695964_j_cclm-2026-0579_ref_027","doi-asserted-by":"crossref","unstructured":"Argentesi, G, Wu, X, Ney, A, Goodchild, E, Laycock, K, Lee, Y-N, et al.. 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