Patients with pheochromocytoma exhibit low aldosterone renin ratio

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA). Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled. Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA. Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.

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Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

10.21203/rs.2.22519/v2 ◽

2020 ◽

Author(s):

Tomoko Yamada ◽

Hidenori Fukuoka ◽

Yusei Hosokawa ◽

Yukiko Odake ◽

Kenichi Yoshida ◽

...

Keyword(s):

Operating Characteristic ◽

Adrenal Adenoma ◽

Characteristic Curve ◽

Plasma Renin ◽

Cross Sectional Study ◽

University Hospital ◽

Adrenal Tumors ◽

Cross Sectional ◽

Plasma Aldosterone Concentration ◽

Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registrationThis study was not registered because of the retrospective analysis.

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Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

10.21203/rs.2.22519/v3 ◽

2020 ◽

Author(s):

Tomoko Yamada ◽

Hidenori Fukuoka ◽

Yusei Hosokawa ◽

Yukiko Odake ◽

Kenichi Yoshida ◽

...

Keyword(s):

Operating Characteristic ◽

Adrenal Adenoma ◽

Characteristic Curve ◽

Plasma Renin ◽

Cross Sectional Study ◽

University Hospital ◽

Adrenal Tumors ◽

Cross Sectional ◽

Plasma Aldosterone Concentration ◽

Sensitive Marker

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Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

10.21203/rs.2.22519/v4 ◽

2020 ◽

Author(s):

Tomoko Yamada ◽

Hidenori Fukuoka ◽

Yusei Hosokawa ◽

Yukiko Odake ◽

Kenichi Yoshida ◽

...

Keyword(s):

Operating Characteristic ◽

Adrenal Adenoma ◽

Characteristic Curve ◽

Plasma Renin ◽

Cross Sectional Study ◽

University Hospital ◽

Adrenal Tumors ◽

Cross Sectional ◽

Plasma Aldosterone Concentration ◽

Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registration This study was not registered because of the retrospective analysis.

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Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

BMC Endocrine Disorders ◽

10.1186/s12902-020-00620-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Tomoko Yamada ◽

Hidenori Fukuoka ◽

Yusei Hosokawa ◽

Yukiko Odake ◽

Kenichi Yoshida ◽

...

Keyword(s):

Operating Characteristic ◽

Adrenal Adenoma ◽

Characteristic Curve ◽

Plasma Renin ◽

Cross Sectional Study ◽

University Hospital ◽

Adrenal Tumors ◽

Cross Sectional ◽

Plasma Aldosterone Concentration ◽

Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA). Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n = 18), SCS (n = 18), and NFA (n = 31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled. Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3 ~ 2.8) vs. 0.7 (0.5 ~ 1.8) and 0.9 (0.6 ~ 1.4) ng/mL/h; p = 0.018 and p = 0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5 ~ 79.5) vs. 156.0 (92.9 ~ 194.5) and 114.9 (90.1 ~ 153.4); p = 0.001 and p < 0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA > 1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR < 95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA. Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registration This study was not registered because of the retrospective analysis.

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MicroRNAs-1299, -126-3p and -30e-3p as Potential Diagnostic Biomarkers for Prediabetes

Diagnostics ◽

10.3390/diagnostics11060949 ◽

2021 ◽

Vol 11 (6) ◽

pp. 949

Author(s):

Cecil J. Weale ◽

Don M. Matshazi ◽

Saarah F. G. Davids ◽

Shanel Raghubeer ◽

Rajiv T. Erasmus ◽

...

Keyword(s):

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Characteristic Curve ◽

Predictive Ability ◽

Roc Curves ◽

Tolerance Test ◽

Cross Sectional Study ◽

Oral Glucose ◽

Cross Sectional ◽

Receiver Operating

This cross-sectional study investigated the association of miR-1299, -126-3p and -30e-3p with and their diagnostic capability for dysglycaemia in 1273 (men, n = 345) South Africans, aged >20 years. Glycaemic status was assessed by oral glucose tolerance test (OGTT). Whole blood microRNA (miRNA) expressions were assessed using TaqMan-based reverse transcription quantitative-PCR (RT-qPCR). Receiver operating characteristic (ROC) curves assessed the ability of each miRNA to discriminate dysglycaemia, while multivariable logistic regression analyses linked expression with dysglycaemia. In all, 207 (16.2%) and 94 (7.4%) participants had prediabetes and type 2 diabetes mellitus (T2DM), respectively. All three miRNAs were significantly highly expressed in individuals with prediabetes compared to normotolerant patients, p < 0.001. miR-30e-3p and miR-126-3p were also significantly more expressed in T2DM versus normotolerant patients, p < 0.001. In multivariable logistic regressions, the three miRNAs were consistently and continuously associated with prediabetes, while only miR-126-3p was associated with T2DM. The ROC analysis indicated all three miRNAs had a significant overall predictive ability to diagnose prediabetes, diabetes and the combination of both (dysglycaemia), with the area under the receiver operating characteristic curve (AUC) being significantly higher for miR-126-3p in prediabetes. For prediabetes diagnosis, miR-126-3p (AUC = 0.760) outperformed HbA1c (AUC = 0.695), p = 0.042. These results suggest that miR-1299, -126-3p and -30e-3p are associated with prediabetes, and measuring miR-126-3p could potentially contribute to diabetes risk screening strategies.

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Diagnostic Test Efficacy of Meibomian Gland Morphology and Function

Scientific Reports ◽

10.1038/s41598-019-54013-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Jiaxin Xiao ◽

Muhammed Yasin Adil ◽

Jonatan Olafsson ◽

Xiangjun Chen ◽

Øygunn A. Utheim ◽

...

Keyword(s):

Dry Eye ◽

Operating Characteristic ◽

Characteristic Curve ◽

Tear Film ◽

Cross Sectional Study ◽

Meibomian Gland ◽

Clinical Parameters ◽

Cross Sectional ◽

And Function ◽

Breakup Time

AbstractMeibomian gland dysfunction (MGD) is the leading cause of dry eye and proposed treatments are based on disease severity. Our purpose was to establish reliable morphologic measurements of meibomian glands for evaluating MGD severity. This retrospective, cross-sectional study included 100 MGD patients and 20 controls. The patients were classified into dry eye severity level (DESL) 1–4 based on symptoms and clinical parameters including tear-film breakup time, ocular staining and Schirmer I. The gland loss, length, thickness, density and distortion were analyzed. We compared the morphology between patients and controls; examined their correlations to meibum expressibility, quality, and DESL. Relative to controls, the gland thickness, density and distortion were elevated in patients (p < 0.001 for all tests). The area under the receiver operating characteristic curve was 0.98 (95% confidence interval [CI], 0.96–1.0) for gland loss, and 0.96 (CI 0.91–1.0) for gland distortion, with a cutoff value of six distorted glands yielding a sensitivity of 93% and specificity of 97% for MGD diagnosis. The gland distortion was negatively correlated to the meibum expressibility (r = −0.53; p < 0.001) and DESL (r = −0.22, p = 0.018). In conclusion, evaluation of meibomian gland loss and distortion are valuable complementary clinical parameters to assess MGD status.

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The Correlation Between Arterial Lactate and Venous Lactate in Patients With Sepsis and Septic Shock

Journal of Intensive Care Medicine ◽

10.1177/0885066616663169 ◽

2016 ◽

Vol 33 (2) ◽

pp. 116-120 ◽

Cited By ~ 14

Author(s):

Pongdhep Theerawit ◽

Chalermpon Na Petvicharn ◽

Viratch Tangsujaritvijit ◽

Yuda Sutherasan

Keyword(s):

Characteristic Curve ◽

Cross Sectional Study ◽

University Hospital ◽

Strongly Correlated ◽

Cross Sectional ◽

Arterial Lactate ◽

Paired Samples ◽

The Mean ◽

Sepsis And Septic Shock ◽

The Relationship

Background: Applying peripheral venous lactate instead of arterial lactate in clinical practice is questionable because of deviation between both values. We aimed to find the relationship between the arterial lactate and the peripheral venous lactate before reasoned that the venous lactate could be used in substitution to the arterial lactate in sepsis. Methods: We conducted a prospective, cross-sectional study at a university hospital. The patients with sepsis in ICU who required lactate level monitoring were enrolled in this research. The correlation and agreement between arterial lactate (A-LACT) and peripheral venous lactate (V-LACT) were the primary outcomes. Results: A total of 63 paired samples were collected. The A-LACT and V-LACT were strongly correlated ( r = .934, P < .0001, r2 = .873). The regression equation was A-LACT = (0.934 × V-LACT) − 0.236. The mean difference between V-LACT and A-LACT was 0.66 ± 1.53 mmol/L. The 95% limits of agreement were between −3.66 and 2.33 mmol/L. The V-LACT ≥ 4 mmol/L can predict A-LACT level ≥ 4 mmol/L with 87.5% sensitivity and 91.5% specificity, and the area under receiver operating characteristic curve was 0.948. Conclusion: The present study demonstrated a strong correlation between A-LACT and V-LACT, but an agreement between both parameters was poor. We suggest not to use the V-LACT in substitution to the A-LACT in sepsis regarding the absolute value and clearance rate, but the V-LACT ≥ 4.5 mmol/L may be used for predicting the A-LACT ≥ 4 mmol/L.

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Divergence in Accuracy of Diabetes Screening Methods in Tuberculosis Patients: A Cross- Sectional Study from Brazil and Peru

10.21203/rs.3.rs-477898/v2 ◽

2021 ◽

Author(s):

Thomas A. Carmo ◽

Catarina D. Fernandes ◽

José F. Fróes Neto ◽

Davi Neri Araújo ◽

Caian L. Vinhaes ◽

...

Keyword(s):

Operating Characteristic ◽

Glycated Hemoglobin ◽

Characteristic Curve ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Screening Methods ◽

Cross Sectional ◽

Tuberculosis Patients ◽

Tuberculosis Diagnosis ◽

Total Accuracy

Abstract Background: To evaluate the accuracy of distinct diabetes mellitus (DM) screening methods in persons with active Tuberculosis PWTB.Methods: Levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at the time of tuberculosis diagnosis at the study clinics were assessed from two distinct retrospective cohorts of PWTB from Brazil (n=116) and Peru (n=136) to evaluate accuracy for detecting pre-DM and DM cases. Additionally, we investigated the association of clinical and sociodemographic factors with tuberculosis and pre-DM or DM in each country.Results: When comparing PWTB from Brazil and Peru, Peruvian individuals presented higher FPG levels at baseline (median [IQR] 91 [81–106 vs 95 [88.4–102.1]]; p=0.02), while those from Brazil had significant higher levels of HbA1c (median [IQR] 6.3 [5.7-7.15] vs 5.1 [4.9-5.4]; p<0.01). Additional analysis using the receiver operating characteristic curve revealed that the markers showed distinct accuracy to identify dysglycemia among PWTB in each country. Conclusion: Our findings indicate that there are significant differences in the total accuracy of the glycemic screening methods evaluated between PWTB from two highly endemic countries from South America, highlighting the need to revisit the diagnostic criteria of DM/PDM in individuals with tuberculosis.

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Ratio of height to thyromental distance: a comparison with Mallampati and Upper lip Bite test for predicting difficult intubation in Pakistani population

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1215 ◽

2021 ◽

pp. 1-15

Author(s):

Saman Tauheed Ali ◽

Khalid Samad ◽

Syed Amir Raza ◽

Muhammad Qamarul Hoda

Keyword(s):

Predictive Value ◽

Characteristic Curve ◽

Cross Sectional Study ◽

Difficult Laryngoscopy ◽

University Hospital ◽

Upper Lip ◽

Cross Sectional ◽

Elective Surgical Procedures ◽

Lehane Grade ◽

Sensitivity Specificity

Objectives: We conducted this study to compare the accuracy of three diagnostic tests; ratio of height to thyromental distance (RHTMD), Modified Mallampati Test (MMT) and Upper Lip Bite Test (ULBT) in predicting difficult laryngoscopy using Cormack and Lehane grade as gold standard.Methods: This study was conducted in Aga Khan University Hospital, Karachi. Based on calculated sample size, 383 patients who required endotracheal intubation for elective surgical procedures were enrolled with consecutive sampling techniques during August 2014 to August 2015 for this cross-sectional study. Primary investigator used RHTMD, ULBT, and MMT for assessing the airway and correlated with laryngoscopic view.Results: A total of 383 patients were incorporated in this research, out of which 59(15.4%) classified as difficult laryngoscopy based on Cormack and Lehane (CL) grading. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of RHTMD (84.7%, 90.1%, 60.9%, 97%, 89.3%) and ULBT (83.1%, 89.2%, 58.3%, 96.7%, 88.3%) values were highest as compared to MMT (30.5%, 84.3%, 26.1%, 86.9%, 79.9%). The area under a receiver-operating characteristic curve (AUC of ROC curve) for ULBT and RHTMD was significantly more than for MMT (P<0.01). RHTMD and ULBT both are acceptable alternatives for prediction of difficult laryngoscopy as a simple, single bed-side test. Continuous...

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Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus in a Semi-Urban Brazilian Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193598 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3598 ◽

Cited By ~ 1

Author(s):

Nayla Cristina do Vale Moreira ◽

Renan M. Montenegro ◽

Haakon E. Meyer ◽

Bishwajit Bhowmik ◽

Ibrahimu Mdala ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Glycated Hemoglobin ◽

Characteristic Curve ◽

Area Under The Curve ◽

Cross Sectional Study ◽

Brazilian Population ◽

Model Assessment ◽

Cross Sectional ◽

Sensitive Marker

The study evaluated glycated hemoglobin (HbA1c) as a diagnostic tool for diabetes and pre-diabetes in the Brazilian population. Further, the homeostasis model assessment of insulin resistance (HOMA-IR) was also examined against HbA1c values to identify the most suitable cut-off points for HOMA-IR to predict the risk of diabetes. A cross-sectional study was conducted among 714 randomly selected subjects. HbA1c, fasting, and 2 h plasma glucose values were measured. Insulin resistance estimates were calculated with HOMA-IR. The receiver operating characteristic curve assessed HbA1c performance. The adjusted prevalence rate of diabetes mellitus was 14.7%, and pre-diabetes 14.2%. The optimal HbA1c cut-off value was ≥6.8% for the diagnosis of diabetes, and ≥6.0% for pre-diabetes. The area under the curve using HbA1c was 0.85 (95% CI: 0.80–0.90) for detecting diabetes and 0.61 (95% CI: 0.55–0.67) for pre-diabetes. The optimal HOMA-IR cut-off value was 2.06 for HbA1c at 6.8%. The HbA1c cut-off value of ≥6.8% may be suitable for diagnosing diabetes in the Brazilian population. Our results do not support the use of HbA1c to diagnose pre-diabetes. A HOMA-IR cut-off point of 2.06 was a sensitive marker to assess the risk of diabetes.

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