Review
Biochemistry & Molecular Biology
Fabio Bioletto, Martina Bollati, Chiara Lopez, Stefano Arata, Matteo Procopio, Federico Ponzetto, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: Primary aldosteronism is recognized as the most common cause of secondary hypertension, associated with high-risk phenotypes and increased cardiovascular morbidity. Excessive aldosterone secretion can contribute to the development of hypertension and drug resistance through various mechanisms and worsen end-organ damage.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Peripheral Vascular Disease
Gregory L. Hundemer, Haris Imsirovic, Anand Vaidya, Nicholas Yozamp, Remi Goupil, Francois Madore, Mohsen Agharazii, Greg Knoll, Manish M. Sood
Summary: Primary aldosteronism is a common but highly underdiagnosed cause of hypertension that leads to disproportionately high rates of cardiovascular disease. However, the population-level uptake of guideline recommendations for primary aldosteronism screening is exceedingly low, highlighting the need for increased education and awareness to bridge this gap.
Article
Endocrinology & Metabolism
Fabio Bioletto, Chiara Lopez, Martina Bollati, Stefano Arata, Matteo Procopio, Federico Ponzetto, Guglielmo Beccuti, Giulio Mengozzi, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: This study investigated the feasibility of using aldosterone-to-renin ratio (ARR) as a diagnostic criteria for primary aldosteronism (PA) in patients with resistant hypertension (RH). The results showed that in normokalemic patients, ARR had a lower diagnostic accuracy and may not accurately differentiate between PA and essential RH. However, in patients with hypokalemia, ARR had a higher diagnostic accuracy and may serve as a diagnostic criterion for PA.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Review
Biochemistry & Molecular Biology
Kiyotaka Itcho, Kenji Oki, Haruya Ohno, Masayasu Yoneda
Summary: Primary aldosteronism (PA) is the most common form of secondary hypertension, with two main subtypes: aldosterone-producing adenoma (APA) and bilateral idiopathic hyperaldosteronism. Recent advancements in genetic analysis have led to the discovery of mutations in causative genes, contributing to a better understanding of the mechanism of excess aldosterone synthesis.
Article
Peripheral Vascular Disease
Theodore W. Kurtz, R. Curtis Morris Jr, Michal Pravenec, Heidi L. Lujan, Stephen E. DiCarlo
Summary: Previous studies suggest that hyperaldosteronism initiates hypertension by increasing sodium retention and blood volume. However, this study found that aldosterone can also promote salt sensitivity and initiation of salt-dependent hypertension by increasing peripheral vascular resistance and decreasing cardiac output.
Review
Peripheral Vascular Disease
Konstantinos Stavropoulos, Konstantinos P. Imprialos, Dimitrios Patoulias, Alexandra Katsimardou, Michael Doumas
Summary: The review summarized the latest data on the association between primary aldosteronism and resistant hypertension, emphasizing the importance of screening all patients with resistant hypertension for primary aldosteronism. Epidemiological data suggests that up to 20% of patients with resistant hypertension may have primary aldosteronism. Patients with this condition are at increased risk of renal disease, diabetes mellitus, atrial fibrillation, and obstructive sleep apnea, and they also have extended target organ damage and higher cardiovascular morbidity and mortality. Specific treatments, such as adrenalectomy and mineralocorticoid receptor antagonists, can significantly reduce blood pressure, reverse target organ damage, and mitigate cardiovascular risk. Therefore, evaluating all patients with resistant hypertension for primary aldosteronism is crucial for improving their quality of life and cardiovascular profile.
CURRENT HYPERTENSION REPORTS
(2022)
Article
Peripheral Vascular Disease
James M. Luther, Dawei S. Wei, Kakali Ghoshal, Dungeng Peng, Gail K. Adler, Adina F. Turcu, Hui Nian, Chang Yu, Carmen C. Solorzano, Ambra Pozzi, Nancy J. Brown
Summary: Epoxyeicosatrienoic acids (EETs) are lipid signaling molecules generated by the action of CYP450s, with vasodilatory, anti-inflammatory, and insulin-enhancing effects. Treatment of primary aldosteronism led to an increase in EET concentrations, particularly 14,15-DHETs.
Article
Endocrinology & Metabolism
Paolo Mulatero, Chiara Bertello, Franco Veglio, Silvia Monticone
Summary: Primary aldosteronism is an overlooked condition with significant mortality and morbidity. The difficulty of screening patients on antihypertensive therapy has resulted in low testing rates. However, interference with medication may not always be necessary for accurate screening.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Tazuru Fukumoto, Hironobu Umakoshi, Masatoshi Ogata, Maki Yokomoto-Umakoshi, Yayoi Matsuda, Misato Motoya, Hiromi Nagata, Yui Nakano, Norifusa Iwahashi, Hiroki Kaneko, Norio Wada, Takashi Miyazawa, Ryuichi Sakamoto, Yoshihiro Ogawa
Summary: This study aimed to explore the role of two confirmatory tests in the subtype diagnosis of primary aldosteronism (PA). The results showed that patients with discordant results between confirmatory tests are highly likely to have a bilateral subtype on adrenal vein sampling (AVS).
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Peripheral Vascular Disease
Gian Paolo Rossi, Filippo Crimi, Giacomo Rossitto, Laurence Amar, Michel Azizi, Anna Riester, Martin Reincke, Christoph Degenhart, Jiri Widimsky, Mitsuhide Naruse, Jaap Deinum, Leo Schultze Kool, Tomaz Kocjan, Aurelio Negro, Ermanno Rossi, Gregory Kline, Akiyo Tanabe, Fumitoshi Satoh, Lars Christian Rump, Oliver Vonend, Holger S. Willenberg, Peter J. Fuller, Jun Yang, Nicholas Yong Nian Chee, Steven B. Magill, Zulfiya Shafigullina, Marcus Quinkler, Anna Oliveras, Vin Cent Wu, Zuzana Kratka, Giulio Barbiero, Michele Battistel, Teresa Maria Seccia
Summary: Imaging can accurately identify unilateral primary aldosteronism in most young patients, especially those with a unilateral adrenal nodule and hypokalemia, but adrenal vein sampling is still necessary for patients without nodules/bilateral nodules or hypokalemia.
Review
Peripheral Vascular Disease
John W. Funder, Robert M. Carey
Summary: Primary aldosteronism, the most common secondary form of hypertension, may have a higher prevalence than previously estimated. The screening rate for primary aldosteronism is currently low, and more research is needed to explore screening and treatment methods.
Review
Cardiac & Cardiovascular Systems
Xiao Lin, Muhammad Hasnain Ehsan Ullah, Xiong Wu, Feng Xu, Su-Kang Shan, Li-Min Lei, Ling-Qing Yuan, Jun Liu
Summary: This review summarizes the cerebro-cardiovascular risk in primary aldosteronism (PA) and emphasizes the harmful effects of excess aldosterone on target organs. Both surgical and medical treatments show long-term benefits in improving cerebro-cardiovascular outcomes and reducing mortality. Understanding these risks is essential for early diagnosis and treatment.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Endocrinology & Metabolism
Denise Bruedgam, Christian Adolf, Holger Schneider, Paul Schwarzlmueller, Lisa Mueller, Laura Handgriff, Martin Bidlingmaier, Sonja Kunz, Petra Zimmermann, Sinan Deniz, Tracy Ann Williams, Felix Beuschlein, Martin Reincke, Daniel A. Heinrich
Summary: This study aimed to investigate whether postoperative ACTH stimulated PAC can predict biochemical remission in patients with PA. The results showed that low postoperative ACTH stimulated PAC levels were predictive of biochemical remission.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Martina Bollati, Chiara Lopez, Fabio Bioletto, Federico Ponzetto, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: Primary aldosteronism, the most common cause of secondary hypertension, not only affects blood pressure and electrolyte balance, but also has pro-inflammatory, pro-oxidant, and pro-fibrotic effects on the kidney, blood vessels, and heart, leading to potential harmful consequences. Clinical studies have shown that primary aldosteronism is associated with an increased risk of atrial fibrillation and aortic ectasia.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Cardiac & Cardiovascular Systems
Gian Paolo Rossi, Giacomo Rossitto, Laurence Amar, Michel Azizi, Anna Riester, Martin Reincke, Christoph Degenhart, Jiri Widimsky, Mitsuhide Naruse, Jaap Deinum, Leo Schultze Kool, Tomaz Kocjan, Aurelio Negro, Ermanno Rossi, Gregory Kline, Akiyo Tanabe, Fumitoshi Satoh, Lars Christian Rump, Oliver Vonend, Holger S. Willenberg, Peter J. Fuller, Jun Yang, Nicholas Yong Nian Chee, Steven B. Margill, Zulfiya Shafigullina, Marcus Quinkler, Anna Oliveras, Bo-Ching Lee, Vin Cent Wu, Zuzana Kratka, Teresa M. Seccia, Livia Lenzini
Summary: This study aimed to determine the rate of drug-resistant arterial hypertension in patients with primary aldosteronism (PA) and investigate the diagnostic performance of adrenal vein sampling (AVS). The results showed that resistant hypertension was common in PA patients, and AVS-guided adrenalectomy effectively resolved treatment-resistant hypertension.
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2022)
Article
Biochemistry & Molecular Biology
Martina Bollati, Chiara Lopez, Fabio Bioletto, Federico Ponzetto, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: Primary aldosteronism, the most common cause of secondary hypertension, not only affects blood pressure and electrolyte balance, but also has pro-inflammatory, pro-oxidant, and pro-fibrotic effects on the kidney, blood vessels, and heart, leading to potential harmful consequences. Clinical studies have shown that primary aldosteronism is associated with an increased risk of atrial fibrillation and aortic ectasia.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Endocrinology & Metabolism
Mirko Parasiliti-Caprino, Fabio Bioletto, Filippo Ceccato, Chiara Lopez, Martina Bollati, Maria Chiara Di Carlo, Giacomo Voltan, Denis Rossato, Giuseppe Giraudo, Carla Scaroni, Ezio Ghigo, Mauro Maccario
Summary: This study evaluated the reliability of simple and corrected aldosterone indices for assessing the selectivity and lateralization of adrenal vein sampling (AVS) in patients with primary aldosteronism. The results showed that the aldosterone index had high accuracy in predicting selectivity and moderate accuracy in predicting ipsi/contralateral aldosterone hypersecretion. The study also found that the use of corrected aldosterone indices significantly improved the accuracy in predicting ipsi/contralateral disease. The comparative aldosterone index showed high accuracy in predicting unilateral primary aldosteronism.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
F. Bioletto, A. M. Berton, E. Varaldo, D. Cuboni, C. Bona, M. Parasiliti-Caprino, N. Prencipe, E. Ghigo, S. Grottoli, M. Maccario, V Gasco
Summary: This study developed an integrated model for the prediction of central adrenal insufficiency (CAI) when morning cortisol is in the grey zone. The model showed better diagnostic performance than using morning cortisol alone, and a new predictive score (CAI-score) was proposed, which can help reduce the number of patients who need stimulation tests for the assessment of HPA axis function.
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
(2023)
Article
Endocrinology & Metabolism
Mitsuhide Naruse, Masanori Murakami, Takuyuki Katabami, Tomaz Kocjan, Mirko Parasiliti-Caprino, Marcus Quinkler, Matthieu St-Jean, Sam O'Toole, Filippo Ceccato, Ivana Kraljevic, Darko Kastelan, Mika Tsuiki, Jaap Deinum, Edelmiro Menendez Torre, Troy Puar, Athina Markou, George Piaditis, Kate Laycock, Norio Wada, Marianne Aardal Grytaas, Hiroki Kobayashi, Akiyo Tanabe, Chin Voon Tong, Nuria Valdes Gallego, Sven Gruber, Felix Beuschlein, Lydia Kuerzinger, Norlela Sukor, Elena A. B. Aisha Azizan, Oskar Ragnarsson, Michiel F. Nijhoff, Giuseppe Maiolino, Guido Di Dalmazi, Valentina Kalugina, Andre Lacroix, Raluca Maria Furnica, Tomoko Suzuki
Summary: This study investigated the diversity of approaches utilized for each diagnostic step in different expert centers regarding primary aldosteronism (PA). The results showed significant variations in blood sampling conditions, assay methods, screening and confirmatory tests among centers. This diversity may lead to inconsistent diagnosis of PA and limit comparison of evidence between centers. Standardization of the diagnostic process and revisiting the concept of mild PA are necessary.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Federico Ponzetto, Mirko Parasiliti-Caprino, Fabio Settanni, Antonello Nonnato, Giulio Mengozzi, Ezio Ghigo, Roberta Giordano
Summary: The simultaneous measurement of dexamethasone and cortisol has shown to improve the diagnostic performance of the overnight dexamethasone-suppression test. Additionally, monitoring the levels of corticosteroid drugs can help investigate unexpected changes in steroid hormone levels. This study developed and validated an LC-MS/MS method for quantifying cortisol, cortisone, dexamethasone, and other corticosteroids in serum/plasma samples. The method was successfully applied to patients undergoing the dexamethasone-suppression test and those receiving immunosuppressive treatment after kidney transplant.
Review
Endocrinology & Metabolism
Fabio Bioletto, Marco Barale, Nunzia Prencipe, Alessandro Maria Berton, Mirko Parasiliti-Caprino, Valentina Gasco, Ezio Ghigo, Massimo Procopio, Silvia Grottoli
Summary: This meta-analysis investigated the role of trabecular bone score (TBS) in assessing bone quality and fracture risk in patients with acromegaly. The results showed that TBS was significantly lower in acromegalic patients compared to controls, and acromegalic patients with vertebral fractures had lower TBS. These findings suggest that TBS could be valuable in evaluating and managing skeletal fragility in acromegalic patients.
NEUROENDOCRINOLOGY
(2023)
Letter
Endocrinology & Metabolism
M. Parasiliti-Caprino, E. Ghigo, M. Maccario
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
(2023)
Article
Agriculture, Dairy & Animal Science
Barbara Bruno, Cristiana Maurella, Paola Gianella, Giulio Mengozzi, Erica Ferraris, Antonio Borrelli
Summary: This study observed the haemostasis characteristics in dogs undergoing surgery for malignancies, using rotational thromboelastometry and thrombin generation. The results showed a trend of hypercoagulability 24 hours after surgery and a return to pre-surgery state after 2 weeks.
Review
Biochemistry & Molecular Biology
Chiara Lopez, Chiara Bima, Martina Bollati, Fabio Bioletto, Matteo Procopio, Stefano Arata, Daniele Giuseppe Candela, Guglielmo Beccuti, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: Glycemic alterations are common in patients with PPGL, but the incidence of secondary DM is uncertain due to lack of prospective multicenter studies. The main mechanisms of glucose homeostasis alterations in PPGL are impaired insulin and GLP-1 secretion and increased insulin resistance. Different pathways leading to glucose intolerance may be related to the secretory phenotype of the tumor. Predictive factors for glucose intolerance in PPGL patients include higher age, more anti-hypertensive drugs, and secreting neoplasms. Tumor resection is strongly associated with resolution of DM and improved glycemic control.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Chemistry, Analytical
Federico Ponzetto, Mirko Parasiliti-Caprino, Iacopo Gesmundo, Lorenzo Marinelli, Antonello Nonnato, Raul Nicoli, Tiia Kuuranne, Giulio Mengozzi, Ezio Ghigo, Fabio Settanni
Summary: The urinary steroidal module of Athlete Biological Passport is currently used to detect anti-doping rule violations related to the abuse of endogenous anabolic androgenic steroids. However, alternative strategies such as the measurement of blood concentrations of endogenous steroid hormones by LC-MS have been proposed due to limitations of the urine test. This study presents a UHPLC-MS/MS method for quantifying major circulating steroid hormones and their metabolites, showing promising results for measuring blood steroid profile markers.
Article
Neurosciences
Alessandro Maria Berton, Mirko Parasiliti-Caprino, Nunzia Prencipe, Fabio Bioletto, Chiara Lopez, Chiara Bona, Marina Caputo, Francesca Rumbolo, Federico Ponzetto, Fabio Settanni, Valentina Gasco, Giulio Mengozzi, Ezio Ghigo, Silvia Grottoli, Mauro Maccario, Andrea Silvio Benso
Summary: In patients with type 2 diabetes, SGLT2i drugs increase plasma AVP levels to balance osmotic diuresis. This process is mainly driven by intracellular dehydration rather than extracellular dehydration. The extent of fluid reduction is affected by the patient's baseline volume conditions.
FRONTIERS IN NEUROSCIENCE
(2023)
Article
Endocrinology & Metabolism
Fabio Bioletto, Chiara Lopez, Martina Bollati, Stefano Arata, Matteo Procopio, Federico Ponzetto, Guglielmo Beccuti, Giulio Mengozzi, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: This study investigated the feasibility of using aldosterone-to-renin ratio (ARR) as a diagnostic criteria for primary aldosteronism (PA) in patients with resistant hypertension (RH). The results showed that in normokalemic patients, ARR had a lower diagnostic accuracy and may not accurately differentiate between PA and essential RH. However, in patients with hypokalemia, ARR had a higher diagnostic accuracy and may serve as a diagnostic criterion for PA.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Health Care Sciences & Services
Francesco Chiara, Sarah Allegra, Jacopo Mula, Maria Paola Puccinelli, Giuliana Abbadessa, Giulio Mengozzi, Silvia De Francia
Summary: Orotic acid is an intermediate metabolite of pyrimidine nucleotide biosynthesis and plays a role in various physiological processes. Measurement of its concentration in urine can help diagnose hereditary metabolic diseases. This study found that females had higher levels of orotic acid in pediatric age, suggesting potential gender differences in pyrimidine intermediate biosynthesis. These findings have implications for understanding the biochemical aspects of pyrimidine biosynthesis and its related disorders.
JOURNAL OF PERSONALIZED MEDICINE
(2023)