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オオツキ ミチオ
Michio Otsuki
大月 道夫 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Basal Plasma Aldosterone Concentration Predicts Therapeutic Outcomes in Primary Aldosteronism |
| 掲載誌名 | 正式名：Journal of the Endocrine Society. 略 称：J Endocr Soc ISSNコード：24721972 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 4(4),pp.bvaa011 |
| 著者・共著者 | Saiki, A. Otsuki, M. Mukai, K. Hayashi, R. Shimomura, I. Kurihara, I. Ichijo, T. Takeda, Y. Katabami, T. Tsuiki, M. Wada, N. Ogawa, Y. Kawashima, J. Sone, M. Inagaki, N. Yoshimoto, T. Okamoto, R. Takahashi, K. Kobayashi, H. Tamura, K. Kamemura, K. Yamamoto, K. Izawa, S. Kakutani, M. Yamada, M. Tanabe, A. Naruse, M. |
| 担当区分 | 2nd著者,責任著者 |
| 発行年月 | 2020 |
| 概要 | Purpose: Normal basal plasma aldosterone concentration (PAC) reflects mild aldosterone excess compared to high basal PAC. We previously reported lower risk for cardiovascular and cerebrovascular events in patients with primary aldosteronism (PA) and normal basal PAC (nPA) than in those with high basal PAC (hPA). However, the differences in therapeutic outcomes between nPA and hPA are unclear. The aim of this multi-institutional, retrospective cohort study was to determine the clinical significance of nPA to therapeutic outcomes, including adrenalectomy (ADX) and treatment with mineralocorticoid receptor antagonists (MRAs). Methods: A total of 1146 patients with PA who were diagnosed and underwent adrenal venous sampling (AVS) between January 2006 and October 2016 were enrolled. The clinical parameters at baseline and after ADX or treatment with MRA were compared between the nPA and hPA groups. Results: Significantly higher rates of absent clinical success (36.6 vs. 21.9%, P = 0.01) and absent biochemical success (26.4 vs. 5.2%, P<0.01) were found for the nPA group than for the hPA group, respectively. Logistic regression analysis identified baseline PAC as a significant independent predictor of absent clinical success of ADX and MRAs. Conclusions: Plasma aldosterone concentration at baseline was a significant and independent predictor of absent clinical success of ADX and MRA. Mineralocorticoid receptor antagonist treatment appeared to be a better therapeutic choice than ADX in the nPA group. |
| DOI | 10.1210/jendso/bvaa011 |
| 文献番号 | 32190802 |