{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:54:37Z","timestamp":1791262477796,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current clinical practice guidelines recommend adrenal venous sampling (AVS) for subtype classification in patients with primary aldosteronism (PA) who are candidates for adrenalectomy; however, AVS may be considered unnecessary in selected young patients with a high probability of unilateral disease. The additional diagnostic information provided by baseline and saline infusion test (SIT)-derived biochemical parameters when evaluated alongside clinical and radiological features remains uncertain. We aimed to compare the diagnostic performance of baseline and SIT-derived biochemical parameters for predicting unilateral PA and to evaluate the additional diagnostic information provided by each parameter when individually added to a common clinical-radiological framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 73 patients with PA (41 unilateral and 32 bilateral) who underwent successful AVS for subtype classification. Baseline plasma aldosterone concentration (PAC), baseline aldosterone-to-potassium ratio (APR), post-SIT PAC, SIT-derived APR, and the suppression index were evaluated. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis, while their associations within a common clinical-radiological model were evaluated using multivariable logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Post-SIT PAC and SIT-derived APR showed the highest numerical discriminative performance among the evaluated biochemical parameters for predicting unilateral PA (AUC\u00a0=\u00a00.817 and 0.837, respectively). Adding either parameter individually to the common clinical-radiological model significantly improved model fit (likelihood-ratio\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.014 and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.028, respectively); however, the increases in AUC were not statistically significant (\u0394AUC = 0.022,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.185 and \u0394AUC = 0.017,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.107, respectively). Post-SIT PAC and SIT-derived APR were strongly correlated (Spearman\u2019s \u03c1 = 0.983,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001), and their ROC-derived thresholds yielded concordant classifications in 97.3% of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that post-SIT PAC shows useful discriminative performance for predicting unilateral PA and may contribute to subtype assessment when considered alongside clinical and radiological features. These findings require validation in independent cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1923356","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:26:09Z","timestamp":1791260769000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic value of saline infusion test\u2013derived biochemical parameters for primary aldosteronism subtyping"],"prefix":"10.3389","volume":"17","author":[{"given":"Yusuf","family":"\u00d6zt\u00fcrk","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Sakarya University Training and Research Hospital","place":["Sakarya, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feridun","family":"Karakurt","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Necmettin Erbakan University Faculty of Medicine","place":["Konya, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1472","article-title":"Study heterogeneity and estimation of prevalence of primary aldosteronism: A systematic review and meta-regression analysis","volume":"101","author":"K\u00e4yser","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002510","article-title":"Genetics, prevalence, screening and confirmation of primary aldosteronism: A position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension","volume":"38","author":"Mulatero","year":"2020","journal-title":"J Hypertens"},{"key":"B3","doi-asserted-by":"publisher","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"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10596","article-title":"Adrenalectomy lowers incident atrial fibrillation in primary aldosteronism patients at long term","volume":"71","author":"Rossi","year":"2018","journal-title":"Hypertension"},{"key":"B5","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s11886-021-01516-0","article-title":"Therapeutic outcomes with surgical and medical management of primary aldosteronism","volume":"23","author":"Wachtel","year":"2021","journal-title":"Curr Cardiol Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1205988","article-title":"Predictors of successful outcome after adrenalectomy for unilateral primary 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(Oxf)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002348","article-title":"Aldosterone-potassium ratio predicts primary aldosteronism subtype","volume":"38","author":"Puar","year":"2020","journal-title":"J Hypertens"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/s42000-024-00548-9","article-title":"Clinical prediction model for primary aldosteronism subtyping and special focus on adrenal volumetric assessment","volume":"23","author":"Barlas","year":"2024","journal-title":"Hormones (Athens)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1244342","article-title":"Integration of clinical parameters and CT-based radiomics improves machine learning assisted subtyping of primary hyperaldosteronism","volume":"14","author":"Mansour","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-20-0073","article-title":"Confirmatory testing of primary aldosteronism with saline infusion test and LC-MS\/MS","volume":"184","author":"Fuss","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00210-2","article-title":"Diagnosis and treatment of primary aldosteronism","volume":"9","author":"Reincke","year":"2021","journal-title":"Lancet Diabetes Endocrinol"}],"container-title":["Frontiers in 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