The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion
The management of patients with adrenocorticotropic hormone-independent Cushing’s syndrome and bilateral adrenal masses is challenging. Adrenal venous sampling (AVS) has been used to identify functional lesions in previous studies, but it is not always reliable. The present study aims to address the...
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Wiley
2019-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2019/2860810 |
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| author | Wenjing Zhang Keying Zhu Hongyun Li Yan Zhang Dalong Zhu Xuebin Zhang Ping Li |
| author_facet | Wenjing Zhang Keying Zhu Hongyun Li Yan Zhang Dalong Zhu Xuebin Zhang Ping Li |
| author_sort | Wenjing Zhang |
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| description | The management of patients with adrenocorticotropic hormone-independent Cushing’s syndrome and bilateral adrenal masses is challenging. Adrenal venous sampling (AVS) has been used to identify functional lesions in previous studies, but it is not always reliable. The present study aims to address the variability of cortisol in the adrenal veins of patients without excessive cortisol secretion and investigate the use of adrenal androgens to correct the cortisol lateralization ratio in AVS. Thirty-seven patients with primary aldosteronism underwent successful AVS. Patients with normal cortisol secretion exhibited a wide range of cortisol concentrations in the right (601-89, 400 nmol/l) and left (331-35, 300 nmol/l) adrenal veins. The median cortisol gradients between adrenal venous and peripheral venous samples were 15.25 and 10.14 in the right and left sides, respectively, and the cortisol lateralization ratio (high side to low side) was as high as 9.49 (median 1.54). The mean plasma levels of cortisol in the adrenal venous and peripheral venous samples decreased from t-15 to t0. Significant positive correlations were observed between the cortisol concentrations and both androstenedione and dehydroepiandrosterone concentrations in the right and left adrenal veins. After correcting for androstenedione or dehydroepiandrosterone levels, the cortisol lateralization ratio was less than 2 in most adrenal venous samples. The present study demonstrated the wide variation in cortisol concentrations in the adrenal veins of patients with normal cortisol secretion. The adrenal androgens might be ideal analytes used as normalizers when assessing the cortisol lateralization of AVS in normal or hypercortisolism cases. |
| format | Article |
| id | doaj-art-1743127066f040b4ae5903e158d156f4 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | International Journal of Endocrinology |
| spelling | doaj-art-1743127066f040b4ae5903e158d156f42025-02-03T07:23:49ZengWileyInternational Journal of Endocrinology1687-83371687-83452019-01-01201910.1155/2019/28608102860810The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol SecretionWenjing Zhang0Keying Zhu1Hongyun Li2Yan Zhang3Dalong Zhu4Xuebin Zhang5Ping Li6Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Imaging, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaDepartment of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, ChinaThe management of patients with adrenocorticotropic hormone-independent Cushing’s syndrome and bilateral adrenal masses is challenging. Adrenal venous sampling (AVS) has been used to identify functional lesions in previous studies, but it is not always reliable. The present study aims to address the variability of cortisol in the adrenal veins of patients without excessive cortisol secretion and investigate the use of adrenal androgens to correct the cortisol lateralization ratio in AVS. Thirty-seven patients with primary aldosteronism underwent successful AVS. Patients with normal cortisol secretion exhibited a wide range of cortisol concentrations in the right (601-89, 400 nmol/l) and left (331-35, 300 nmol/l) adrenal veins. The median cortisol gradients between adrenal venous and peripheral venous samples were 15.25 and 10.14 in the right and left sides, respectively, and the cortisol lateralization ratio (high side to low side) was as high as 9.49 (median 1.54). The mean plasma levels of cortisol in the adrenal venous and peripheral venous samples decreased from t-15 to t0. Significant positive correlations were observed between the cortisol concentrations and both androstenedione and dehydroepiandrosterone concentrations in the right and left adrenal veins. After correcting for androstenedione or dehydroepiandrosterone levels, the cortisol lateralization ratio was less than 2 in most adrenal venous samples. The present study demonstrated the wide variation in cortisol concentrations in the adrenal veins of patients with normal cortisol secretion. The adrenal androgens might be ideal analytes used as normalizers when assessing the cortisol lateralization of AVS in normal or hypercortisolism cases.http://dx.doi.org/10.1155/2019/2860810 |
| spellingShingle | Wenjing Zhang Keying Zhu Hongyun Li Yan Zhang Dalong Zhu Xuebin Zhang Ping Li The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion International Journal of Endocrinology |
| title | The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion |
| title_full | The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion |
| title_fullStr | The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion |
| title_full_unstemmed | The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion |
| title_short | The Value of Adrenal Androgens for Correcting Cortisol Lateralization in Adrenal Venous Sampling in Patients with Normal Cortisol Secretion |
| title_sort | value of adrenal androgens for correcting cortisol lateralization in adrenal venous sampling in patients with normal cortisol secretion |
| url | http://dx.doi.org/10.1155/2019/2860810 |
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